title: Gluteal Implants Versus Autologous Flaps in Patients with Postbariatric Surgery Weight Loss: A Prospective Comparative Study of 3-Dimensional Gluteal Projection After Lower Body Lift.
abstract: BACKGROUND
  Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem.
  
  
  OBJECTIVE
  We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL.
  
  
  METHODS
  Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared.
  
  
  RESULTS
  The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 mL. Operation time was shorter in the flap group (192 min) than in the implant group (218 min, P = 0.001). Surgeon satisfaction was higher in the implant group (P = 0.007). Implants were more painful than flaps at 4 days and 2 weeks (P = 0.004 for both). There were 6 minor complications (60%) in the implant group versus 7 (50%) in the flap group (P = 0.94).
  
  
  CONCLUSIONS
  In selected patients, LBL with gluteal implants is safe and slightly increases gluteal projection.
  
  
  METHODS
  2.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Levan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
authors.forename: Samer
authors.initials: S
authors.lastname: Bassilios Habre
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D002081:Buttocks / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011446:Prospective Studies; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014182:Transplantation, Autologous / Q000379:methods; D015431:Weight Loss; D055815:Young Adult