Abstract
BACKGROUND: Buttock augmentation is increasingly popular in body contouring but remains controversial within the surgical community, partly due to limited larger scale studies on cohesive gel buttock implants, in contrast to the extensive data available for breast implants. The author previously described a composite buttock augmentation technique involving subcutaneous expansion vibration lipofilling and later proposed a dual-plane pocket dissection for improved implant stability. METHODS: A retrospective review was conducted on 482 patients who underwent buttock augmentation using the same surgical technique by a single surgeon from June 2020 to May 2022. After excluding cases involving secondary implants or additional mesh, 423 patients were included. All patients received composite augmentation, consisting of an implant combined with fat grafting. RESULTS: In the 423 dual-plane procedures, the average surgery time was 1 hour and 50 minutes, with follow-up ranging from 21 to 55 months. The overall complication rate related to implants was 10.8%, with seroma being the most frequent issue. Complications were categorized based on whether they stemmed from the implant or from the liposuction/fat grafting component and were analyzed for frequency, severity, and resolution. CONCLUSIONS: Composite buttock augmentation using a dual-plane pocket technique offers the benefits of both submuscular and intramuscular dissection. This method provides better soft tissue coverage and implant stability, presenting it as a reliable and effective technique for gluteal enhancement.