Surgical pocket location for gluteal implants: a systematic review.
BACKGROUND
The safest pocket location for gluteal augmentation surgery using implants still is unknown. This study conducted a systematic review to derive evidence-based recommendations concerning the safest type of pocket location (sub-muscular, subfascial, intramuscular, or intramuscular XYZ method) for silicone implants in terms of acute and long-term complication rates.


METHODS
Articles from medline that met predetermined criteria were included in the study. The outcomes of interest included wound dehiscence, wound infection, seroma, hematoma, implant asymmetry, and capsular contracture. Pooling of statistical data was performed when possible.


RESULTS
The authors reviewed 30 articles regarding five different types of pocket locations for gluteal implants described since 1969. The most common complications after gluteal augmentation surgery using implants are wound dehiscence (10.29%), seroma (2.49%), wound infection (1.12%), and hematoma (0.24%). Fulfilled expectations after surgery were assessed differently among studies and could not be compared.


CONCLUSIONS
The pocket locations for gluteal augmentation surgery with implants that have the lowest complication rates are the following: intramuscular XZY method (13.18%), sub-muscular (17.60%), intramuscular (18.05%), and subfascial (54.84%).


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 .
Clínica Gerardo Flores-Lima, Hospital de Diagnostico de El Salvador, 91 Avenida Norte #541 Colonia Escalón, San Salvador, El Salvador. floresguandique@hotmail.com
Gerardo
G
Flores-Lima
Barry L
BL
Eppley
Joaquín R
JR
Dimas
David E
DE
Navarro
D002081:Buttocks / Q000033:anatomy & histology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods*; D018570:Risk Assessment; D020034:Silicone Gels; D013518:Surgery, Plastic / Q000379:methods; D016896:Treatment Outcome
D020034:Silicone Gels