Buttock augmentation with silicone implants: a multicenter survey review of 2226 patients.

BACKGROUND: Enhancement of buttock volume with gluteal silicone implants has been performed by surgeons for over 30 years, but no studies have examined complication rates or outcomes of more than single-surgeon experiences. Numerous technical differences in how gluteal augmentation surgery with implants is performed also exist, and to date, surgeon preferences for implant plane, incisional access, implant type, and drain use have not been quantified. METHODS: A 10-question survey was sent to 83 targeted members of the American Society of Plastic Surgeons requesting information about number of cases performed, duration of surgeon experience, implant placement plane and incisional access, implant type, length of typical surgery, use of drains and antibiotic irrigation solution, surgeon satisfaction and surgeon assessment of patient satisfaction, and number of complications experienced. RESULTS: Nineteen respondents (25 percent response rate) provided data on 2226 patients. Thirteen respondents (68.4 percent) favored the intramuscular plane of dissection over the subfascial plane. Preference for incisional access was nearly equally divided between a single incision in the gluteal cleft (10 respondents) and two incisions separated within the cleft (nine respondents). The total number of complications reported was 848 (38.1 percent). CONCLUSIONS: Gluteal augmentation with silicone implants has gained popularity in the last decade. Despite this, no previous studies have examined multisurgeon experiences with this procedure to determine complication rates or surgeon technical preferences. The authors present data from a survey sent to experienced gluteal augmentation surgeons. Advances in technique and implant options are needed to improve complication rates experienced with this procedure.

Ultrasonically assisted face-lift.

BACKGROUND: The face-lift procedure is one of the most skillful interventions performed by plastic surgeons. Ultrasonic energy is used to elevate the facial skin flap, which allows for preservation of vascular, lymphatic, and nervous structures, thereby decreasing the morbidity associated with this procedure. METHODS: A retrospective study to compare the outcomes of ultrasound and non-ultrasound-assisted face-lifts is reported. All the procedures were performed at the Institute for Plastic Surgery. Each group consisted of 104 patients. Statistical analysis was performed to determine differences between the groups. RESULTS: The mean operating time was 4 h in the treatment group versus 4.2 h in the control group (p>0.05). The incidence of hematoma formation was 0.96% in the treatment group versus 2.4% in the control group (p<0.05). The incidence of flap necrosis was 0% in both groups. The duration of ecchymosis was 13 days in the experimental group versus 17.2 days in the control group (p<0.05). The duration of postoperative swelling was 17.4 days in the treatment group versus 20.4 days in the control group (p<0.05). As reported, 85% of patients in the treatment group were very satisfied, 14.42% were satisfied, 0% were mildly satisfied, and 0% were not satisfied. In the control group, 80.7% were very satisfied, 18.26% were satisfied, 0.96% were mildly satisfied, and 0% were not satisfied. According to Fisher's exact test, the p value for patient satisfaction exceeded 0.05%. CONCLUSIONS: The preservation of the blood and lymphatic vessels diminishes postoperative swelling and shortens the duration of ecchymosis considerably. The incidence of hematoma formation is lower than with a non-ultrasonic face-lift. This study failed to prove any statistically significant difference in operating time or patient satisfaction between the two groups.

Subfascial technique for gluteal augmentation.

The author performs gluteal augmentation by inserting implants into subfascial pockets after using templates and sizers to determine implant size. He reports that this technique yields good projection, is easily reproducible, and provides predictable results.