{'fraction_non_alphanumeric': 0.025081788440567066, 'fraction_numerical': 0.024536532170119956, 'mean_word_length': 5.284246575342466, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Gluteal Augmentation With Fat: Retrospective Safety Study and Literature Review

BACKGROUND
Use of gluteal augmentation with fat increased by 3267% from 2002 to 2015, and the rate of death is highest compared with other aesthetic procedures: 1 in 3448 patients dies, compared with 1 in 55,000.


OBJECTIVES
To retrospectively investigate patients who underwent this procedure at Oslo Plastic Surgery Clinic, to review international data to determine factors causing mortality, and to provide guidelines for safety.


METHODS
Patient data were searched for reason for the procedure, assessment of patients, techniques performed, and safety measures used. In 60 cases, a vibration machine was used for fat harvesting. Review of the international literature, with special emphasis on fatal complications, was performed on Medline, Google Scholar, and PubMed.


RESULTS
Mean patient age was 32 years. Mean amount of grafted fat was 422 mL (range, 210-850 mL). Sedation, local and tumescent anesthesia were used in all patients, with mobilization directly after surgery. Mean operation time was 89 minutes. Eighteen patients required a second surgery. Minor complications occurred in 8 patients. Average follow-up was 8 months. Ninety percent of patients were satisfied. Review of international literature showed that the main reason for death in 2015 was fat lung embolism related to muscular and submuscular grafting.


CONCLUSIONS
Gluteal augmentation with fat is one of the most popular procedures, with an internationally high mortality rate. Patient safety is a priority, and preventive measures should improve safety because appropriate patient selection, avoiding muscular and submuscular grafting, avoiding infragluteal incision, moderate grafted volume, and direct postoperative mobilization are essential.


LEVEL OF EVIDENCE: 4