title: Gluteal Augmentation with Silicone Implants: A New Proposal for Intramuscular Dissection.
abstract: BACKGROUND
  Gluteoplasty has gained notoriety over the last decades, which has motivated the development of various surgical techniques. Nevertheless, the fear of dissection of the intramuscular plane without direct visualization may inhibit learning and development of gluteal augmentation with implants. Moreover, literature detailing the technical steps of intramuscular dissection for the construction of the implant pocket is scarce. This study presents a new approach to intramuscular dissection for gluteal augmentation with silicone implants, a variation of the conventional surgical technique.
  
  
  METHODS
  We performed a retrospective analysis of a series of 12 female patients submitted to a variation of the intramuscular dissection technique for gluteal augmentation with silicone implants. Data from patients, implants, follow-up time, postoperative complications, and the degree of patient satisfaction were obtained. This technique follows the principle of alternating spatulas to perform the blunt dissection of the implant pocket.
  
  
  RESULTS
  In this series, the proposed technique is controlled and safe for intramuscular dissection, which can be used for both experienced and training surgeons. This technique is based on well-known anatomical points and references. We observed that the implant was well positioned and covered, the patients were satisfied with the result, and the number of complications was low.
  
  
  CONCLUSIONS
  This variation of the intramuscular dissection technique for gluteal augmentation with silicone implants provides an easily reproducible and safe procedure that involves well-controlled technical steps, especially during dissection of the intramuscular pocket. In this series of patients, training surgeons learned faster, results were satisfactory, and the number of complications was low.
  
  
  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: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Guilherme Augusto
authors.initials: GA
authors.lastname: Andrade
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil. pscoltro@hotmail.com.
authors.forename: Pedro Soler
authors.initials: PS
authors.lastname: Coltro
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Andó
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Renan Victor
authors.initials: RV
authors.lastname: Lima
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Bruno Francisco
authors.initials: BF
authors.lastname: Müller Neto
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Vinicius Zolezi
authors.initials: VZ
authors.lastname: Silva
authors.affiliation: Division of Plastic Surgery, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 9º andar, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Jayme Adriano
authors.initials: JA
authors.lastname: Farina Junior
mesh_terms: D000328:Adult; D001938:Brazil; D002081:Buttocks / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D020034:Silicone Gels; D013518:Surgery, Plastic / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020034:Silicone Gels
keywords: Buttocks; Prosthesis implantation; Surgical procedures, operative