title: Gluteal implant displacement: diagnosis and treatment.
abstract: BACKGROUND
  First reported in 1969, buttocks implant surgery has evolved greatly since the introduction of the intramuscular technique. This technique provides good implant coverage and protects the sciatic nerve from compression. However, it enables the occurrence of a new complication, intramuscular hernia or implant displacement. The goal of this research study is to describe, classify, and standardize the treatment of gluteal implant displacement.
  
  
  METHODS
  The treatment algorithm was developed after dissection of fresh human cadavers and analysis of computed tomographic scans in patients with implant displacement. After elaborating the treatment protocol for implant displacement, it was prospectively applied in 24 patients that presented with visible implants.
  
  
  RESULTS
  Intramuscular dissection has proven to be technically possible when a minimum of 2 cm of muscle thickness is achieved. One-stage surgery was applied in 41 buttocks (21 patients). The control computed tomographic scan obtained 3 months after surgery has shown fibrosis in the buttocks area, corresponding to the subcutaneous capsule housing the implant in the anomalous position. The operative wound complications were more frequent, and treatment failure with relapse of the implant superficial displacement occurred in only one of 47 buttocks (2.1 percent).
  
  
  CONCLUSIONS
  The treatment of gluteal implant displacement can be a one-stage surgical procedure for most patients. This decision is based on the thickness of the gluteus maximus muscle just below the implant.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Rio de Janeiro, Brazil From the Plastic Surgery Service, Pedro Ernesto University Hospital, Rio de Janeiro State University.
authors.forename: Fernando
authors.initials: F
authors.lastname: Serra
authors.forename: José Horácio
authors.initials: JH
authors.lastname: Aboudib
mesh_terms: D000465:Algorithms; D002081:Buttocks / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods