title: Bilateral sciatic nerve axonotmesis after gluteal lipoaugmentation.
abstract: The number of lipoaugmentation procedures, and specifically the number of gluteal lipoaugmentations, has risen dramatically over the past decade. Though gluteal lipoaugmentation confers a pleasing hourglass profile with seemingly minimal risk, its risks have not been fully realized. We report the case of a healthy 35-year-old woman who suffered axonotmesis of the sciatic nerve due to direct lipoinjection into and around the nerve sheath. She was treated expectantly in our Peripheral Nerve Clinic for 3 months without evidence of improvement. Subsequently, she underwent internal and external neurolysis. Eighteen weeks after her neurolysis, she continues to demonstrate signs of severe peripheral neuropathy, but has begun to show signs of nerve regeneration. This is the first reported case of sciatic nerve axonotmesis due to gluteal lipoaugmentation. It highlights the importance of a thorough knowledge of gluteal anatomy and a consciousness of the risks involved with lipoaugmentation of deep structures.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Postgraduate Division of Medical School, Universidad Nacional Autónoma de México, México City, Mexico. alexcardenas@hotmail.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Cardenas-Mejia
authors.forename: Jorge Rodríguez
authors.initials: JR
authors.lastname: Martínez
authors.forename: David
authors.initials: D
authors.lastname: León
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Taylor
authors.forename: Claudia
authors.initials: C
authors.lastname: Gutierrez-Gomez
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D002081:Buttocks / Q000294:innervation / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D018570:Risk Assessment; D012584:Sciatic Nerve / Q000293:injuries / Q000473:pathology; D020426:Sciatic Neuropathy / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D013518:Surgery, Plastic / Q000009:adverse effects* / Q000379:methods; D015626:Tissue Expansion / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome