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16 Buttock Reshaping: Principles andTechniques Using Vaser Device andFat Grafting
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@AlbertoDiGiuseppe @AlbertoDiGiuseppe
a
de
@AlbertoDiGiuseppe @AlbertoDiGiuseppe
b @AlbertoDiGiuseppec
Fig. 16.20 39-year-old woman, round shape buttock. VASER to torso, anks, and abdomen. 1200 cc of total fat transfer. Pre op (a, b, d). 1year
post op (c, e)
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cd
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A. Di Giuseppe and F. Giovagnoli
@AlbertoDiGiuseppe @AlbertoDiGiuseppe
a
b
@AlbertoDiGiuseppe @AlbertoDiGiuseppe
Fig. 16.21 24-year-old woman, round shape buttock. VASER to torso, anks, and anterior thighs. VASER smooth for cellulite. 1000 cc of total
fat transfer. Pre op (a, c). 1year post op (b, d)
16 Buttock Reshaping: Principles andTechniques Using Vaser Device andFat Grafting
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221
Fig. 16.22 24-year-old
woman, round shape buttock.
VASER to torso, anks, and
anterior thighs. VASER
smooth for cellulite. 1000 cc
of total fat transfer. Immediate
post-op result in posterior (a),
lateral (b) and oblique-upper
(c) view
@AlbertoDiGiuseppe
a
@AlbertoDiGiuseppe
b
@AlbertoDiGiuseppe
c
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https://t.me/medicina_free
A. Di Giuseppe and F. Giovagnoli
a
@AlbertoDiGiuseppe
@AlbertoDiGiuseppe
b
@AlbertoDiGiuseppe
c
Fig. 16.23 38-year-old patient, slim frame, but unhappy about contouring of anks, poor denition, and at buttocks. Droopy buttocks and
banana fold deformity. (a, c, e) pre op. (b, d, f) 6month post op
@AlbertoDiGiuseppe
d
16 Buttock Reshaping: Principles andTechniques Using Vaser Device andFat Grafting
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@AlbertoDiGiuseppee @AlbertoDiGiuseppef
Fig. 16.23 (continued)
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224
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A. Di Giuseppe and F. Giovagnoli
@AlbertoDiGiuseppe
a
@AlbertoDiGiuseppe
c @AlbertoDiGiusepped
@AlbertoDiGiuseppe
b
Fig. 16.24 44-year-old patient, two pregnancies, overweighted, with bulge and apron of the abdominal wall. On the back, rolls, heavy anks, back
rolls, and torso laxity. Complaining also for at and unshaped buttocks. (a, c, e, g) pre op. (b, d, f, h) 6month post op. (i, l) Immediate post op
16 Buttock Reshaping: Principles andTechniques Using Vaser Device andFat Grafting
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225
@AlbertoDiGiuseppe
e
@AlbertoDiGiuseppe
g
@AlbertoDiGiuseppe
f
@AlbertoDiGiuseppe
h
Fig. 16.24 (continued)
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Fig. 16.24 (continued)
A. Di Giuseppe and F. Giovagnoli
@AlbertoDiGiuseppei @AlbertoDiGiuseppel
Fig. 16.25 Analysis of body
frame
16 Buttock Reshaping: Principles andTechniques Using Vaser Device andFat Grafting
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a b c d
227
e f
i l
g h
Fig. 16.26 Pre post VASER liposuction upper and lower abdomen, anterior and posterior anks, back rolls, and trunk. (a, c, e, g, i) pre op. (b, d,
f, h, l) 6months post op
16.7 Safety Issues
16.7.1 Zone ofAdherence
In buttock shaping and fat transfer, the zone of adherence and
vascular danger zone must be considered. Adherence zones are
mainly localized at the gluteal fold. They are vertical connec-
tive structures localized at the gluteal fold, which are in intimate connection with the dermal attachment of the buttocks.
Those vertical connections should not be destroyed during surgery. This 2cm large area at the gluteal fold must be
preserved from any surgical vertical work.
In case of accidental distraction, the buttocks will drop
over the fold, or the gluteal fold itself will be lowered, creat-
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A. Di Giuseppe and F. Giovagnoli
ing severe damage, nearly impossible to be corrected, except
with an open surgical approach.
16.7.2 Vascular Danger Zone
In buttocks enhancement, extreme care must be followed in
directing fat transfer:
(a) Using blunt instruments.
(b) 2–3mm large cannulas with an open place on the lower
side of the cannula.
(c) Inltration subdermal.
(d) Avoid intramuscular inltration for the presence of large
veins with no valves, which could eventually result in a
fat collection and a massive fat embolus.
(e) Always direct the cannula in a horizontal fashion, by
checking the depth with the contralateral hand. Recently
a supercial ultrasound device has been introduced in
the market and is useful for continuously checking the
depth of the cannula while progressing into the buttock
area. Thus preventing uncontrolled penetration of the
fascia and the gluteal muscle (where the gluteal vessels
and the sciatic nerve are located).
16.7.3 Complications
The rst complication I did encounter in my series was an
infection sustained by Streptococcus. The patient had BBL
under general anesthesia, and donor areas were upper and
lower abdomen, posterior anks, and trunk.
The patient had the standard preparation, with betadine
shower a few hours before surgery, then prepping with
chlorhexidine.
Intra op, she had an IV full dose of AMOXICLAV 500/125
(amoxicillin 500mg and clavulanic acid 125mg). She had
500 per side fat transfer to buttock for enhancement and hip
correction.
On discharge, she has prescribed a 5days course of the
same antibiotic orally (AMOXICLAVE per os, twice a day).
Post-op recovery was uneventful until day 5 post-surgery.
Patient started to present a darker left side. This was the
nurse's diagnosis when she saw the photos sent by the patient.
No temperature at the time and no redness in the hip and buttock areas (Fig.16.27).
On day 6, the patient sent photos again, showing quite a
change in the color of the buttocks (Fig.16.28).
The area has become progressively red and warmer; the
patient signed with a permanent marking per the outer limits
Fig. 16.27 Buttock presentation of day 5 after surgery
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