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Aesthetic
Surgery
oftheButtock
AComprehensive Clinical
Guide
DanielDelVecchio
HéctorDurán
Editors
123

Aesthetic Surgery of the Buttock

Daniel DelVecchio • Héctor Durán
Editors
Aesthetic Surgery of the
Buttock
A Comprehensive Clinical Guide

Editors
Daniel DelVecchio
Boston, MA, USA
Héctor Durán
Merida, Yucatán, Mexico
ISBN 978-3-031-13801-0 ISBN 978-3-031-13802-7 (eBook)
https://doi.org/10.1007/978-3-031-13802-7
© Springer Nature Switzerland AG 2023
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microlms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
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claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface
Butt surgery is challenging. Not only does it require anatomy knowledge and stateof-the-art surgical techniques. The butt is also a topic under the social network´s
gaze and scrutiny; it impacts fashion, creates trends, and is also a sexualized area,
both in men and women.
Thinking that operating on a buttock is a simple procedure that does not involve
much science is the perfect recipe for complications.
Operating buttocks only as a simple area, without much science precisely, leads
to complications. The buttock has a very specialized anatomy from the skin to the
depth; thus, there are suitable techniques and particular complications. In addition,
the plastic surgeon must improve his criteria to choose the necessary procedures to
turn the buttock into an instrument of attraction and beauty, minimizing the risks.
This challenge is what inspired us to create this book.
From the beginning, we knew our goal was to bring together the world’s leading
experts in butt aesthetic surgery, to write a chapter where each one could present
their buttock aesthetics experience. In this way, we achieved a compendium not
only limited to fat inltration but also to butt implant surgery, post-bariatric buttock,
and complications.
The reader will have the opportunity to review all these topics quickly and simply. You will notice that there are worldwide authors, but especially from Latin
America, where body contouring surgery keeps an enormous development.
However, we also decided to address a problem often observed despite health
warnings, especially in evolving countries: the inltration of inappropriate substances into the buttocks. This situation is already a severe health problem. I asked
the author who addresses this chapter to share with the reader an overview of why
this is a problem, its natural evolution, the surgical techniques to address it, and how
he usually aids these patients.
We have also invited surgeons with spectacular outcomes in buttock contouring
surgery with fat inltration to explain how they do it and their vision of beauty. If
there is something they do differently, we might achieve it also in our patients.
v

vi
Preface
Likewise, we couldn’t be peaceful if we had not included plastic surgeons to
write about safety and avoid catastrophes during fat inltration. Understanding the
concepts of MIFE (Microscopic Fat Embolism) and the most fatal MAFE
(Macroscopic Fat Embolism) helps us to avoid procedures that can set our patients
at risk during surgery. Avoiding it is the duty of every surgeon working on the buttocks. But distinguishing it and adequately treating it should also be an obligation if
it happens.
We conceived this book a little time before the COVID pandemic began. This
world event delayed its appearance. But now that it is with you, I would ask the
reader to enjoy it and learn from it, wishing you hold the best and most complete
book of buttocks body contouring surgery in your hands. I hope we have succeeded.
I thank all the chapters’ authors who responded to my and Dan’s invitation. I
know their friendship and affection are imprinted in each of the chapters. Thank you
all for your effort and dedication.
I thank Dan Del Vecchio for being a friend, mentor, and teacher to me. From the
moment I proposed to make this book, he accepted and guided me in the process.
Beyond all, I admire how he has changed the buttock fat inltration concept to avoid
complications. I am very sure the world has avoided many fatalities due to this. This
example, for me, is a goal that I will always try to follow.
And without a doubt, my gratitude and admiration to whom I love, God and my
family. To my wife Cecilia, my sons Hector and Roberto, and my parents Hector
and Virginia. Thank you for being willing to continue without me so I can embark
daily on this challenging and crazy task, which I believe can help improve this
world and this beautiful specialty, even if this effort is a tiny mustard seed.
Merida, Yucatán, Mexico HectorC.Duran

Contents
Part I Anatomy and Aesthetic Concept
1 Modern and Integral Anatomy of the Gluteal Region:
FROD’S Intramuscular Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Freddy Rodriguez Garcia
2 The Buttocks: Anthropologic and Cultural Evolution . . . . . . . . . . . . 31
Chris Khorsandi
3 Artistic Anatomy of the Gluteal and Lumbosacral Area. . . . . . . . . . . 37
Stefan Danilla
Part II Safety in Buttock Surgery
4 Practice Advisory on Gluteal Fat Grafting . . . . . . . . . . . . . . . . . . . . . . 49
Daniel Del Vecchio
5 Real Time Intraoperative Ultrasound Guidance
Can Make Any Gluteal Fat Grafting Procedure Safe . . . . . . . . . . . . . 67
Pat Pazmino
6 Safety Comparison of Abdominoplasty and
Brazilian Butt Lift: How Dangerous Is BBL? . . . . . . . . . . . . . . . . . . . 87
Daniel Del Vecchio
7 Safety in Gluteal Fat Infiltration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Lazaro Cardenas-Camarena
8 Deaths Caused by Gluteal Lipoinjection: What
Have We Learned from Microscopic and Macroscopic Fat
Embolism? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Héctor Durán, Lázaro Cárdenas, Daniel Del Vecchio, Jorge Bayter,
Alvaro Luiz Cansançao, and William Peña
vii

viii
Contents
9 Avoiding Complications in Buttock Surgery . . . . . . . . . . . . . . . . . . . . 129
David Orozco-Rentería, Guillermo Ramos-Gallardo,
Jesús Cuenca-Pardo, and Lázaro Cárdenas-Camarena
Part III Fat Science
10 The Science Behind the Fat Graft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Gabriel A. Mecott and Sheyla Geraldine Hernández-Soto
Part IV Surgical Technique in Fat Transfer
11 Preferred Surgical Techniques in Fat
Transplantation to the Gluteal Region:
Antigravitational Liposculpture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Alejandro Najar Mendez
12 Gluteal Fat Augmentation – Our Personal Approach . . . . . . . . . . . . . 187
Rodrigo G. Rosique and Marina J. F. Rosique
13 Preferred Surgical Techniques in Fat
Transplant to the Gluteal Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Alexander Aslani and Miguel G. Bravo
14 S-Curve® Gluteal Augmentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Daniel Gould and Ashkan Ghavami
15 The Lipocontour Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Héctor Durán
16 Buttocks Dynamic Definition (HD2) Liposuction: for
Adipose Harvesting and Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Alfredo Hoyos and Mauricio Perez
Part V Buttock Implants
17 Gluteal Augmentation in Males – A Composite
Approach Using Silicone Implant and Lipocell Transfer . . . . . . . . . . 255
Douglas S. Steinbrech and Eduardo Gonzalez
18 Overcoming Fear in Gluteal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Paulo Godoy
19 Anatomical Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Patricio Covarrubias
20 Round Implants for Buttock and Hip Augmentation . . . . . . . . . . . . . 279
Gustavo Gaspar Blanco and Brenda Briseno Orozco

Contents
21 Natural Look in Buttock Implants: Eight
Step Hybrid Gluteoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Humberto Uribe Morelli
22 Combining Fat and Implants for Gluteal Augmentation . . . . . . . . . . 303
Alexander Aslani and Miguel G. Bravo
23 Gluteal Implant Associated with Anaplastic
Large Cell Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Guillermo Ramos-Gallardo, Adrián Alejandro Carballo-Zarate,
David Orozco-Rentería, Daniela León, Jesús Cuenca-Pardo,
and Lázaro Cárdenas-Camarena
Part VI The Post-Bariatric Buttock
24 Advanced Techniques for Buttock Restructuring,
Reshaping, and Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Eduardo Ulises Góngora Alejandre and Cynthia Catalina
Solis López
25 The Post-Bariatric Buttock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
Martín Morales-Olivera
26 The “Buttock Augmentation Lipofilled Flap”:
A Novel Approach for Gluteal Contour in the
Post Bariatric Body Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
Rodrigo Munro-Wilson
ix
Part VII Complications
27 Management of Patients with ASIA Syndrome in
Plastic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
Carlos Alberto Ríos, Jaime Alexander Domínguez Quiñonez,
Carlos Alejandro López Albán, and Jhan Arturo
28 Complications in Buttock Implants Surgery:
How to Prevent and Treat Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405
Patricio Covarrubias, Paulo Godoy, and Nicolás Flores
29 Infection in the Operated Buttock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Guillermo Ramos-Gallardo, Miguel Ángel León Hernández, Jesús
Cuenca- Pardo, David Orozco-Rentería, Lazaro Cardenas-Camarena,
and Héctor Durán
30 Secondary Defects of the Buttock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Alvaro Cansanção and Alexandra Condé-Green

x
Contents
Part VIII Postoperative Management of Buttock
31 Drains in Gluteal Augmentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Carlos Oaxaca
32 Gluteal Lipografting: Technique and Transoperative Care . . . . . . . . 445
Andres Fernando, Duran Pinilla, and Andres Villate Hernández
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453
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