One of the most popular plastic surgery procedures nowadays is buttock augmentation, which increases buttock volume and lifts the buttock. Prosthetic gluteal augmentation, local tissue rearrangement, autologous fat grafting, local flaps, and hyaluronic acid gel injection are the five main buttock augmentation procedures that are typically used. According to statistics on cosmetic surgery in the United States, prosthetic buttock augmentation is one of the most widely used methods for buttock augmentation. Several implant insertion techniques have been developed for prosthetic buttock augmentation, including subcutaneous placement, submuscular placement, intramuscular placement, and subfascial placement. After carefully weighing postoperative complications, postoperative effects, and patient satisfaction, many doctors opt for the intramuscular implantation strategy.
The thickest muscle in the human body is the gluteus maximus, measuring 4 to 7 cm. The thick line of the femur, the gluteal tuberosity, and the iliotibial band are where it finishes after beginning at the iliac crest, sacrum, coccyx, and sacrotuberous ligaments. The lateral boundary of the gluteus maximus is drawn from the middle and posterior third of the iliac crest to the greater trochanter, while the upper and lower boundaries of the piriformis are drawn from the posterior superior iliac spine to the coccyx. The sciatic nerve’s point of entry is where the coccyx’s horizontal line intersects the midline of the thigh.
To implant the gluteus maximus prosthesis intramuscularly, Vergara et al. first made a 6-7 cm intergluteal incision 4 cm above the anus, followed by a 6-7 cm incision in the gluteus maximus fascia in the direction of the gluteus maximus fibres. The proper “implant pocket” (the gluteus maximus muscle implant space) is formed by first separating the buttock muscles with the fingers and then tilting them 45 degrees to the deep surface from the lateral and upper bounds.
Gonzalez et al. were the first to state the following guidelines for placing the prosthesis in the gluteus maximus: To keep as much muscle as possible both before and after the prosthesis, the gluteus maximus must be the only area of the body that is dissected. González-Ulloa et al. introduced the bilateral coccygeal region incision, infra-gluteal sulcus incision, and lengthening of the medial gluteal sulcus incision in terms of surgical approach incisions. However, regardless of the surgical technique incision chosen, augmentation surgery is generally performed blindly.
Ethical approval
This study’s procedures for working with human subjects adhered to the Declaration of Helsinki in every way (as revised in 2013). Due to the study’s retrospective nature and anonymity, the Research Ethics Board of Sun Yat-sen Memorial Hospital accepted the procedure without requiring informed permission.
MRI imaging and evaluation
We used a 3.0T machine to examine the pelvis with MRI (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). The MRI sequences included transverse T2WI and coronal T1-weighted imaging (T1WI). The lowest point of the sacroiliac joint (SIJ), the point just above the femoral head, and the ischial tuberosity were the three scanning levels that we defined using the coronal T1WI images. The index of the left- and right-side glutes was then determined using transverse T2WI images at the three levels. There is a list of the specific imaging parameters in. We used post-processing software on a GE MRI workstation to determine the gluteus maximus muscle’s cross-sectional area (GE, Advantage Windows 4.5 workstation; GE Healthcare, Chicago, IL, USA).
