Clinics in Plastic Surgery

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Gluteal augmentation is a quickly evolving field that continues to grow in the realms of patient safety, surgical education, and technological advancement. This article discusses innovation in gluteal augmentation and suggests potential new pathways for developing the practice of gluteal augmentation.

The shape and definition of the male buttock have been emphasized throughout time, as it represents masculinity, strength, health, and beauty across various cultures. Aesthetic Plastic Surgery in general has become more acceptable for men; thus, the demand for gluteal enhancement parallels this shift in social norms. Surgeons interested in such cases must first understand the aesthetic ideals and principles of gluteal shaping as it pertains to men. By using gluteal implants, fat transfer techniques, local tissue rearrangement principles, or a combination thereof, one can sculpt an aesthetically pleasing male buttock with a high degree of patient satisfaction...

Static injection, migration, and equalization allows for always subcutaneous-targeted fat grafting to either the deep or the superficial subcutaneous spaces.

Low-cost, high-resolution ultrasound systems allow surgeons to visualize and manipulate the subcutaneous space and inject fat graft with millimeter accuracy.

The concept of the gluteal framework has significantly enhanced our understanding of the gluteal anatomy. The buttock does not constitute a bulging area in the human body. To be attractive, it must harmonize with all elements of the human body around it. Nevertheless, the changes in patient desires and demands, in addition to innovations in surgical technique open a field of opportunity to achieve more beautiful and natural results. In this work, the main updates in the management of body contouring are condensed, including new safe and aesthetic fat infilration techniques...

Guidelines for optimal buttock implant management, time-efficient preparation of implant pocket, and breakdown of optimal implant choice, combined with large-volume fat transfer for best possible outcome.

Liposuction cannulas are versatile tools in a plastic surgeon's armamentarium useful for dissection, deep subcutaneous ligamentous release, fat extraction, and lipofilling. Experienced surgeons develop the ability to navigate subcutaneous anatomy through real-time tactile feedback of the cannula's depth, angulation, excursion, and resistance. Peripheral gluteal ligaments acting as anatomic boundaries must be understood and protected. However, central ligaments tether the dermis to deeper structures precluding expansion...

Gluteal contouring has been subject to numerous publications in aesthetic plastic surgery. Not only the female but also the male features that govern such procedures have been thoroughly described by different authors. In this article, we will provide the reader with an updated account of how gluteal contouring blends with High Definition Liposculpture (HDL). We discuss the most current techniques for buttocks reshaping through a holistic approach of new anatomical and artistic concepts. We will dive into new techniques to perform multiplanar and 4-dimensional Fat Grafting and equalization of the buttocks and surrounding areas, which we believe might help plastic surgeons to improve the quality of their patient outcomes...

This article explores the importance of understanding the tridimensional artistic anatomy of the back, pelvis, and thighs in gluteal surgery. It emphasizes the need for plastic surgeons to have a comprehensive knowledge of these anatomic structures to achieve successful outcomes. The authors highlight the significance of ethnic differences in determining ideal aesthetic results and stress the importance of considering and respecting these variations. Individualization of treatment is a key principle in gluteal surgery, as each patient has unique preferences and needs...

Demand for autologous gluteal augmentation with fat transfer continues to rise paralleling the increasingly complex nature of the operation. Improved overall aesthetic outcomes are a result of: (1) donor site fat harvest has evolved to circumferential torso high-definition lipo-sculpting; (2) a shift from indiscriminate buttock augmentation to precise gluteal re-shaping. Discussing complex operations with patients, particularly ones of artistic nature, can be challenging. The senior author has developed a gluteal re-shaping graphic to focus a patient's attention to the four most important areas...

Gluteal fat grafting is the fastest growing surgery in body contouring because of the powerful results that no other procedure can achieve. Efforts made to improve the safety of this procedure are reviewed.

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Both nonsurgical and surgical modalities for the treatment of hair loss are being used by providers at an increasing rate worldwide. Men and woman are affected by hair loss, but the pathophysiology of the hair loss is thought to be different between sexes; therefore, gender must play a role in treatment decisions. Currently, there are 3 Food and Drug Administration-approved nonsurgical androgenetic alopecia treatments: minoxidil, finasteride, and low-light laser therapy. Platelet-rich plasma injections are showing promise as a single modality and as an adjunct to other nonsurgical and surgical treatments of androgenetic alopecia...

Nonsurgical skin tightening in the neck is an area of significant growth with seemingly countless devices. Optimal treatment choice depends on the patient's concerns, anatomy, and lifestyle. Patients with minimal skin laxity, but dynamic platysmal bands may benefit from botulinum toxin injections. Mild to moderately lax skin can be addressed with microfocused ultrasound or radiofrequency with microneedling. Significant sun damage and laxity can both be addressed with fractional ablative lasers. Options for submental preplatysmal fat include percutaneous radiofrequency, radiofrequency-helium plasma, deoxycholic acid injections, and cryolipolysis...

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Microneedling, also referred to as percutaneous collagen induction therapy, uses small needles to create mechanical injury to the skin, stimulating the wound-healing cascade and new collagen formation. Compared with other skin resurfacing techniques, microneedling preserves the epidermis and is nonablative, therefore reducing inflammation, downtime, and risk of dyspigmentation. In addition to increasing collagen production in fibroblasts, microneedling also helps normalize cell function of keratinocytes and melanocytes and can be used to increase absorption of topical medications, growth factors, or deliver radiofrequency directly to the dermis...

Cosmetic procedures to combat the effects of aging are increasing in demand. Surgical interventions, such as rhytidectomy, have long been the standard method of providing a more youthful appearance. However, these procedures are costly, often require general anesthesia, and have potential risks such as scarring and prolonged recovery. A safe, effective, alternative to surgery is the nonsurgical thread-lift. Nevertheless, proper patient selection is critical for optimal outcomes and for patient and provider satisfaction...

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Soft tissue filler injections have become the second most common noninvasive cosmetic procedure performed in the United States, accounting for roughly 26% of all noninvasive procedures. As experience with filler injections has increased, so too have the applications and uses throughout the face. The popularity of "liquid," or nonsurgical, rhinoplasty has grown considerably with both patients and surgeons over the last decade. First documented in 2006, numerous descriptions of technique and application have grown in tandem with the increasing popularity of nonsurgical rhinoplasty procedures...