title: Liposculpture and fat grafting for aesthetic correction of the gluteal concave deformity associated with multiple intragluteal injection of penicillin in childhood.
abstract: BACKGROUND
  The gluteal concave deformity, a complication of repeated intragluteal injections in childhood, is a relatively common complaint of many young women in China. This issue could be addressed by lipofilling, as the method could produce aesthetically acceptable results in correcting soft tissue contour defects.
  
  
  METHODS
  Twelve patients with bilateral gluteal concave deformities associated with repeated intragluteal injections were operated on from June 2006 to June 2010. The deformities were classified as major or minor. Overall satisfaction with body appearance after gluteal fat grafting and liposculpture was rated on a scale of 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). The evaluation was performed at 3-44 months after surgery.
  
  
  RESULTS
  The average volume of fat injected was 196.9 ± 41.4 ml. No serious adverse events occurred. One patient with major deformity had one additional fat grafting procedure. One patient developed cellulitis in the feet and lower legs, upon which the grafted areas were incised and drained on suspicion of infection but with negative cultures. The patient recovered uneventfully with intravenous antibiotic application for 7 days. At the office visit nine cases judged that their appearance after the operation as "very good" (4) to "excellent" (5) and three cases responded that their contour was "good." Improvement in skin texture and alleviation of the pigmentation in the concave area were observed in all cases during the 3-44-month follow-up intervals after the fat grafting, and softening of the hypertrophic scar was also observed as early as 1 month after the fat grafting and continuously improved during the 12-month follow-up.
  
  
  CONCLUSIONS
  Autologous lipografting for gluteal concave deformity, combining a liposculpture procedure adjacent to the defects, accomplishes good aesthetic results with high patient satisfaction. The key to success is complete release of fibrosis adhesion, meticulous manipulation of fat grafts, and multitunnel and multiplane injections to ensure maximum take of the grafts.
  
  
  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                      www.springer.com/00266                                        .
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Shanghai, 200011, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Ren
authors.forename: Weigang
authors.initials: W
authors.lastname: Cao
authors.forename: Yayi
authors.initials: Y
authors.lastname: Yang
authors.forename: Shengli
authors.initials: S
authors.lastname: Li
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D002081:Buttocks / Q000002:abnormalities* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D015187:Lipectomy / Q000379:methods*; D010406:Penicillins / Q000009:adverse effects
chemical_list: D010406:Penicillins