Safety of Wireless Ultrasound-Guided Gluteal Fat Grafting

Gluteal fat grafting (or autologous fat transfer to the buttocks) is one of the fastest growing procedures in plastic surgery. However, as the popularity of the procedure has grown, so has the number of fatalities and complications. Fatalities are mainly linked to fat embolism, which can occur when fat is injected into the gluteal muscles, instead of subcutaneously. The use of wireless ultrasound imaging during the procedure can help reduce the chances of intramuscular fat injection and improve patient safety. Here, we present a 36-year-old female underwent circumferential liposuction with autologous fat transfer to the bilateral buttocks. From liposuction, 3500 mL of fat was harvested and 1000 mL of fat was injected into each buttock with wireless ultrasound guidance. We identified the subcutaneous plane where fat was to be injected, avoided penetrating the muscular fascia, and observed (in real-time) fat being introduced into the subcutaneous tissue. Wireless ultrasound-guided gluteal fat grafting is an effective and reliable method of visualizing the anatomy of the gluteal region and preventing intramuscular injection of fat. The technology is readily available, very user-friendly and serves as a great learning tool. Based on our positive experience using ultrasound guidance, larger comparative studies should be conducted to confirm its value.