title: Gluteal reduction: a new technique with tightening, lifting, and reshaping effects on the buttocks.
abstract: BACKGROUND
  Currently, patient demand is increased for procedures to improve the form and size of the gluteal region. Although gluteal augmentation and lifting are the most common aesthetic requirements for the gluteal area, some patients need gluteal reduction. Most surgeons reduce the gluteal volume only by liposuctioning the buttocks. This procedure, however, is inadequate when patients do not have good skin quality. Very few techniques have been described for gluteal reduction, and all of them leave noticeable scars that are unacceptable to most patients. The author presents a new technique to reduce, lift, and tighten the gluteal region using well-hidden incisions.
  
  
  METHODS
  Five female patients who requested gluteal reduction were included in this study. Two of these patients had primary gluteal lipodistrophy, and two had excessive gluteal volume as a consequence of liquid silicone injections in the buttocks. The remaining patient had previously undergone gluteal implants, but after pregnancy ended up having very big buttocks and wanted to reduce the gluteal volume. Gluteal reduction was performed using bilateral incisions that began from the sacral triangle and proceeded downward slightly off the gluteal midline to continue along the infragluteal fold. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. Excess tissue was removed, and wound closure was performed in multiple layers.
  
  
  RESULTS
  The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. No major complications or infections occurred. One of the patients presented with wound dehiscence bilaterally, limited to the central area. This case required wound care for 1 month, after which the wound was closed satisfactorily with the patient under local anesthesia. In all the patients, the gluteal area was reduced, reshaped, and tightened satisfactorily. All five patients were extremely satisfied with the new gluteal shape, the degree of the gluteal reduction, the quality and location of the scars, and the lifting effect associated with this gluteoplasty technique.
  
  
  CONCLUSIONS
  A new technique for gluteal reduction that effectively reduces, tightens, and reshapes the buttocks is presented. Patient acceptance of this surgery is very high because unlike previous gluteal reduction techniques, this procedure leaves well-concealed scars that can be hidden even with the small type of swimsuits used currently.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
authors.affiliation: Universidad de Antioquia, Antioquia, Colombia. jmejiac79@hotmail.com
authors.forename: Jorge Alirio
authors.initials: JA
authors.lastname: Mejia
mesh_terms: D000328:Adult; D002081:Buttocks / Q000601:surgery*; D005260:Female; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*