Intramuscular technique for gluteal augmentation:  determination and quantification of muscle atrophy and implant position by computed tomographic scan.
BACKGROUND
New surgical techniques for gluteal augmentation have improved final results. It is estimated that more than 35,000 patients have undergone augmentation gluteoplasty using implants. The authors sought to determine and quantify the presence of muscle atrophy, and to evaluate implant positioning using the intramuscular technique.


METHODS
Twenty-three female patients were selected prospectively for this study and underwent intramuscular gluteal augmentation using gluteal implants of a round or oval base. Computed tomographic scanning and three-dimensional volumetric reconstruction were used to investigate muscle atrophy and implant position, with comparison of the results between the preoperative scan and scans obtained 3, 6, and 12 months after surgery.


RESULTS
Three-dimensional reconstruction and volumetric analysis showed muscular atrophy. After 12 months of follow-up, 34 gluteal muscles (17 patients) were analyzed, with 4.3 percent atrophy remaining on the right side and 2.6 percent on the left side. Twenty-three patients were studied regarding position (46 gluteal implants). All oval base implants introduced in a vertical direction (seven patients) turned to an oblique direction, following the direction of muscle fibers by 3 months after surgery. Two patients showed rotation of the implant.


CONCLUSIONS
The presence of a gluteal implant caused muscle atrophy. However, it did not lead to clinical or physical limitations. It is not important whether the implants are positioned vertically or obliquely, provided that they are symmetric. The technique proved to be safe in maintaining the intramuscular position of the implant, with good satisfaction for the patients.


METHODS
Therapeutic, IV.
Rio de Janeiro, Brazil From the Plastic Surgery Service, Pedro Ernesto University Hospital, and the Department of General Surgery, Rio de Janeiro State University.
Fernando
F
Serra
José Horácio
JH
Aboudib
Ruy Garcia
RG
Marques
D000328:Adult; D001284:Atrophy; D002081:Buttocks / Q000601:surgery*; D005260:Female; D006801:Humans; D018482:Muscle, Skeletal / Q000473:pathology*; D011446:Prospective Studies; D015642:Radiology, Interventional; D019651:Plastic Surgery Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult