Ahmed Elsaftawy, Michał Bonczar, Marta Jagosz, Patryk Ostrowski
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引用次数: 0
Abstract
Background: Gluteal augmentation is a widely performed aesthetic procedure, with implants providing a reliable alternative for patients with insufficient donor fat or those seeking a more pronounced and predictable volume enhancement. However, complication rates remain a concern, and it is unclear how different surgical techniques influence outcomes such as wound dehiscence, seroma formation, capsular contracture, and implant malposition. This systematic review and meta-analysis aimed to evaluate the safety and complication rates associated with implant-based gluteal augmentation, with a focus on how different surgical and procedural factors may influence these outcomes.
Methods: A systematic search of Medline (PubMed), Embase, Scopus, and Web of Science was conducted following PRISMA guidelines. The ROBINS-I V2 tool was used to assess the risk of bias, and publication bias was analyzed using funnel plots and the LFK index.
Results: A total of 32 studies comprising 2,682 patients were included in the meta-analysis. Textured implants had higher complication rates, including seromas (7.50% vs. 2.56%), dehiscence (13.98% vs. 6.63%), and capsular contracture (2.06% vs. 0.55%) compared to smooth implants. Subfascial placement had the highest seroma (22.25%) and dehiscence (27.07%) rates, whereas intramuscular and submuscular placements showed lower complication rates. The overall implant removal rate was 1.05%, with subfascial placement exhibiting the highest rate (5.23%).
Conclusions: Implant-based gluteal augmentation remains a viable option, but careful selection of surgical technique is crucial to minimize complications. While intramuscular and submuscular placement appear safer, further prospective, standardized studies with long-term follow-up are needed to refine surgical strategies and improve patient outcomes.
背景：臀大是一种广泛应用的美容手术，对于供体脂肪不足或寻求更明显和可预测的体积增加的患者，植入物提供了可靠的选择。然而，并发症的发生率仍然是一个问题，并且不清楚不同的手术技术如何影响结果，如伤口裂开、血清肿形成、包膜挛缩和种植体错位。本系统综述和荟萃分析旨在评估植入性臀肌隆胸术的安全性和并发症发生率，重点关注不同的手术和程序因素如何影响这些结果。方法：按照PRISMA指南系统检索Medline （PubMed）、Embase、Scopus和Web of Science。采用ROBINS-I V2工具评估偏倚风险，采用漏斗图和LFK指数分析发表偏倚。结果：meta分析共纳入32项研究，包括2,682例患者。与光滑种植体相比，纹理种植体的并发症发生率更高，包括血清肿（7.50% vs. 2.56%）、裂开（13.98% vs. 6.63%）和荚膜挛缩（2.06% vs. 0.55%）。筋膜下放置的血清肿（22.25%）和裂孔（27.07%）发生率最高，而肌肉内和肌肉下放置的并发症发生率较低。种植体整体去除率为1.05%，其中筋膜下放置率最高（5.23%）。结论：以植入物为基础的臀肌增强术仍然是一种可行的选择，但谨慎选择手术技术对于减少并发症至关重要。虽然肌内和肌下置入似乎更安全，但需要进一步的前瞻性、标准化的长期随访研究来完善手术策略并改善患者预后。
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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