The hybrid approach in modern gluteoplasty and a proposed decision-making algorithm

The gluteal region is an important aesthetic symbol of the body and represents a major component of sexual attraction. Buttocks descent and atrophy are common presenting complaints for patients seeking elective improvement of their body. Gluteal surgery has a recent history of technique evolution, with various reported methods and refinements, including autologous tissue and alloplastic materials. It has been gaining popularity, and an exponential growth in buttocks procedures has been recorded in the recent years. Modern comprehensive gluteal rejuvenation must address both gluteal atrophy and ptosis. Gluteal implants can give a rounded and enhanced appearance to the buttocks while lifting in the form of excisional techniques can address the ptosis. These techniques may be applied together in one surgical procedure or performed in a staged sequence. This report describes the combination of lifting and enhancement techniques to achieve improvement in the gluteal region. An algorithm, to assist with decision making, based on the gluteal deformity encountered, is also proposed. Two separate clinical examples are described, a patient with gluteal implants with synchronous buttocks lift and a patient with pursestring gluteoplasty followed by gluteal implants at a later time.

Level of Evidence: Level V, therapeutic study.