title: Fat Grafting for Gluteal Augmentation: A Systematic Review of the Literature and Meta-Analysis.
abstract: BACKGROUND
  With the increasing demand for gluteal fat augmentation, reports of fatal complications have surfaced. Therefore, the authors proposed to analyze the published techniques and compare different protocols, to identify those of potential concern.
  
  
  METHODS
  A systematic review of the literature was performed with a search of 21 terms on the PubMed, MEDLINE, Cochrane, and Scientific Electronic Library Online databases. Nineteen articles meeting our predetermined criteria were analyzed, and data from the different steps of the procedure were classified, allowing evaluation and comparison of techniques. Independent-samples t test and one-way analysis of variance were used for statistical analysis.
  
  
  RESULTS
  Seventeen case series and two retrospective studies including 4105 patients were reviewed. Most articles were authored in Colombia, Mexico, and Brazil. Most procedures were performed on adult female patients under general anesthesia. Fat was harvested using a tumescent technique from the lower extremities and the back, with machine-vacuum suction. A mean of 400 ml of decanted lipoaspirate was injected into each gluteal region, mostly subcutaneously and intramuscularly with 60-ml syringes. Most patients rated their results as "excellent." The mean complication rate was 7 percent (6.7 percent minor, 0.32 percent major), with no significant relation to the planes of injection.
  
  
  CONCLUSIONS
  Fat grafting is an effective and predictable way to remodel the gluteal region; however, the procedure is not without risks. Avoiding gluteal vessel damage may prevent most feared complications, such as fat embolism. Accurate analysis, systematization of the procedure, and reporting cases in the fat grafting registry may provide the foundation for optimization of outcomes.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Condé-Green
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Vasanth
authors.initials: V
authors.lastname: Kotamarti
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Nini
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Wey
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Naveen K
authors.initials: NK
authors.lastname: Ahuja
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Granick
authors.affiliation: Newark and New Brunswick, N.J.|From the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and Plastic Surgery Arts of New Jersey.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Lee
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002081:Buttocks / Q000601:surgery*; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D015187:Lipectomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000379:methods; D055815:Young Adult