Gluteal Augmentation Using Subfascial Silicone Implants and Selective Autologous Fat Grafting.

[BACKGROUND] The demand for gluteal augmentation has risen significantly over the past decade. While both implants and autologous fat grafting are commonly used, each technique carries limitations. This study evaluates our outcomes following subfascial gluteal augmentation with silicone implants, with or without adjunctive autologous fat grafting.

[METHODS] This single-centre, retrospective study reviewed 30 patients (23 women and 7 men) who underwent subfascial gluteal augmentation with firm cohesive silicone gel implants between 2023 and 2024. Eleven patients underwent simultaneous autologous fat grafting. Subjective and objective outcomes were assessed using the Global Aesthetic Improvement Scale (GAIS), Objective Buttocks Assessment Scale (OBAS), and the Gluteal Ptosis Classification Scale. Complications and satisfaction scores were recorded for up to 1 year (range 2-52 weeks, median 24).

[RESULTS] Implant volumes ranged from 125 to 715 cc (mean 350 cc females and 283 cc males). About 90% of patients achieved a GAIS score of ≤2, indicating significant aesthetic improvement. OBAS scores improved by an average of 5 points, reflecting enhanced gluteal volume, superior pole projection, and improved waist-to-hip ratios. Three implant-related complications were recorded: implant malrotation (managed non-surgically), infection, and extrusion-both requiring explantation. No cases of capsular contracture, animation deformity, sensorimotor nerve injury, or haematoma were observed. Judicious use of autologous fat grafting was beneficial in patients with thin, soft tissue envelopes and/or pre-existing contour irregularities, including cellulite or contour deformities.

[CONCLUSIONS] Subfascial silicone gluteal implant placement with selective autologous fat grafting appears to be a safe and effective technique for gluteal enhancement. Acceptable complication rates with reasonable patient satisfaction and acceptable aesthetic results may be obtained.

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