Innovative Ultrasound Techniques for Predicting Gluteal Augmentation Outcomes with Muscle-Adipose Flaps

Goals/Purpose: Ptosis and gluteal atrophy are conditions that can arise from various interrelated causes, significantly impacting both aesthetics and function. Aging is a primary factor, as natural declines in muscle mass, skin elasticity, and hormonal changes can contribute to sagging and loss of volume in the gluteal region. Other contributing factors include a sedentary lifestyle, weight fluctuations, pregnancy, and genetics, all of which may result in reduced muscle tone and excess skin. Poor nutrition, particularly insufficient protein and essential nutrients, can further exacerbate muscle wasting. Inadequate strength training or resistance exercises targeting the glutes can prevent the development and maintenance of muscle mass, leading to both ptosis and atrophy over time.

The aim of this study was to predict and preoperatively plan the volume of the buttocks that can be achieved using a muscle-adipose flap.

Methods/Technique: To this end, we developed a formula that calculates the volume of the muscle-adipose flap to be added to the buttocks preoperatively. This formula involves calculating the volume of a parallelepiped (the shape of the flap), where the width and height of the flap are measured through objective examination, and the thickness is determined using ultrasound. Twenty gluteoplasties were performed utilizing this musculo-adipose flap, with surgical planning and prediction of gluteal augmentation conducted for all patients.

Results/Complications: This method allowed for the correlation between the predicted gluteal augmentation and the actual results observed after surgery. The results demonstrated that the preoperative planning method effectively informed expectations and surgical outcomes. The surgical results were both aesthetically and functionally satisfactory, and there were no major complications.

Conclusion: Planning gluteoplasty with a large gluteal muscle-adipose flap using objective data from physical examinations and ultrasound has proven to be a simple, reproducible, and reliable method. This approach not only aids in accurate volume prediction but also assists plastic surgeons in managing patients' expectations regarding their surgical outcomes. Overall, the study highlights the importance of thorough preoperative planning in achieving desired aesthetic results and improving patient satisfaction.