Gluteal augmentation is a challenging procedure in the realm of aesthetic treatments. It demands a thorough understanding of the anatomical framework of the buttock’s region, including the vascular supply, aging and physiological changes, and possible complications.[1]

Currently, different techniques are being used for gluteal or buttocks augmentation. These are:

●   Implants

●   Local tissue rearrangement or local flaps

●   Fat grafting

●  Hyaluronic Acid(HA) fillers[2]

Despite the different options, HA fillers are gaining popularity as they are minimally invasive, have low downtime, and have fewer complications. [3]

Leaning Towards Minimally Invasive Body Procedures

While there is a lot of curiosity about aesthetic enhancement procedures, many people are still skeptical about going for these procedures because they fear going under the knife, which means high recovery time and more risks! That is why they are drifting towards minimally invasive treatments that are faster, easier and have low downtime. Plus, the results are natural!

Buttock or gluteal augmentation with HA fillers is capturing everyone’s attention with its prominent results and low downtime.

Let us delve deep into the science behind HA fillers and understand how they have proven to be a promising solution for nonsurgical gluteal augmentation. [4]

Why Hyaluronic Acid Fillers?

The naturally occurring hyaluronic acid dissolves quickly in the body, so a crosslink modification is required to extend the lifespan of the external HA molecules. In the case of biphasic hyaluronic acid fillers, a heterogeneous mix of highly elastic, crosslinked gel particles are dispersed in the non-crosslinked HA medium. [5]

The biphasic HA fillers exhibit -

- High lifting capacity[6]

- High elasticity and firmness [7]

- Long-lasting effects[6]

- Good safety and tolerability[6]

- Easy injectability[6]

- Uniform distribution under the skin[6]

- Easy integration with the body[6]

HA Fillers For Gluteal Volume Correction

To confirm the effectiveness and safety of HA dermal fillers for buttocks, a five-year study was conducted on patients who’ve undergone buttock augmentation using HA fillers.[8]

The study aimed to assess the long-term safety and efficacy of using HA body fillers in nonsurgical gluteal augmentation and reshaping.

Method Used

This was an observational and retrospective study carried out at multiple locations in Italy (Milan & Rome) and the United Arab Emirates. The selected 91 patients underwent buttocks augmentation between 2017-2021 with HYAcorp MLF1 and HYAcorp MLF2 (BioScience GMBH, Germany) and had a follow-up of almost 4 years and 7 months.

The procedure for HA body fillers was initiated by experienced surgeons, depending on the clinical needs of the participants.

Criteria for Participant’s Selection

The participants included a diverse group aged 22-53 who received gluteal augmentation treatment. The data was recorded in the participating clinic’s databases as a routine clinical practice.  

People who are allergic to antibiotics or lidocaine, underwent a surgical procedure, or had low-grade ptosis and body mass index less than 18 or higher than 30 were excluded.

Filler Properties

The two leading HA body fillers used in the study were (HYAcorp MLF1/ HYAcorp MLF2; BioScience GMBH, Germany) (CE 2409). These biphasic dermal fillers for the body have high particle size and high viscosity.

- HYAcorp MLF1: It is a crosslinked body filler with high particle size. These are designed for contouring and volumizing areas of the body, e.g., volumizing and correcting calves, hands, and concave deformities. It lasts up to 18 months and can be combined with HYAcorp MLF2 to provide smoother and more natural results.

- HYAcorp MLF2: It is a highly crosslinked body filler that works wonders in augmenting and contouring the gluteal area. Its high particle size and HA concentration make it perfect for volumizing buttocks, offering long-lasting results.  

Administration Technique

The study used a fanning technique with a linear retrograde injection of HA fillers. While the fanning technique involves multiple injections from a single puncture point, spreading out in a fan shape, the linear retrograde injection involves the injection of the filler in a straight line.

The treatment area was selected according to the patient’s different needs. This included hip dip contouring wherein the HYAcorp MLF1 with a lower particle size range is selected and injected into the superficial layer of the subcutaneous fat tissue.

Assessment process

The patient’s complete demographic data was collected, along with the number and date of sessions undertaken by each patient. In addition, information was recorded on the volume of HA injected on each side and region, as well as the treatments performed.

- To study the Adverse Events (AEs) of the procedure and assess the safety, pre and post-procedural photographs were used.

- The post-treatment satisfaction level was evaluated using the Global Aesthetic Improvement Scale (GAIS). The participants of the study were assigned a dissociated code that helped gather data through the electronic data collection form.

- The data was collected in anonymized form and had heterogeneous Boolean fields and labels, e.g., age, volume of HA body fillers, dates, region, type of intervention, AE, and places where treatment was performed.

- For primary visualization and correlation between the description data by the patients and the type of treatment performed, the Weka 3.8 Data Mining: Practical Machine Learning Tools and Techniques software was used.

Key Findings

Amongst the 91 participants, 81 were women, 4 were men, and 6 were transsexual. The mean age of the participants was 33.5 years.

- A total of 267 procedures were undertaken. It was found that there were no serious AEs in the follow-up period. Most of the AEs were expected in this type of procedure (like swelling, bruising, itching, and mild inflammation) and only 5.5% of patients witnessed moderate AEs like nodules, allergies, and infection.

- 5 patients attended one session, 25 attended two sessions, 32 attended three treatments, and 29 attended four sessions.

- 44 patients were followed for 2+ years, 17 patients were followed for 1-2 years, and 30 patients were followed during the first year.

- The mean volume of injected HA fillers for the buttocks was 40.86 mL per session per side.

- At subsequent sessions, less volume was required to maintain the same results.  

Research reveals that significantly higher risks are associated with many aesthetic enhancement procedures like implant-based gluteal augmentation [9] but with HYAcorp fillers, the AEs were minor. This study also confirms the high safety and efficacy of these dermal fillers for gluteal augmentation.

Hyaluronic Acid Fillers for Buttock Enhancement – Way Forward

Body contouring has always been a topic of discussion among many; however, with high safety and efficacy, HA fillers have topped the charts.[10] People looking for aesthetic improvements due to aging, weight loss, or lipoatrophy can opt for buttock filler injections as these have fewer complications, are minimally invasive, and have low downtime.[11]

However, it is of utmost importance that the quality of the product used, the volume injected, the technique used, and the participant’s clinical history be taken into consideration so that they can be offered the best treatment without any challenges.

To get more information on body filler treatment, non-surgical butt lift treatment, and HYAcorp MLF1/2, get in touch with our experts and make an informed decision.  

References:

_{[1] Kalaaji, A., Dreyer, S., Vadseth, L., Maric, I., Jönsson, V., & Haukebøe, T. H. (2018). Gluteal Augmentation With Fat: Retrospective Safety Study and Literature Review. Aesthetic Surgery Journal, 39(3), 292–305. https://doi.org/10.1093/asj/sjy153}

_{[2] Oranges, C. M., Tremp, M., Di Summa, P. G., Haug, M., Kalbermatten, D. F., Harder, Y., & Schaefer, D. J. (2017). Gluteal Augmentation Techniques: A Comprehensive Literature Review. Aesthetic Surgery Journal, 37(5), 560–569. https://doi.org/10.1093/asj/sjw240}

_{[3] Salahia, S., & Dar, T. M. (2022). Hyaluronic Acid: A Safe, Biodegradable and Biocompatible Product for Buttock Augmentation and Contouring. European Journal of Medical and Health Sciences, 4(3), 57–61. https://doi.org/10.24018/ejmed.2022.4.3.1344}

_{[4] Mortada, H., Alkadi, D., Saqr, H., Sultan, F., Alturaiki, B., Alrobaiea, S., Aljaaly, H. A., Arab, K., & Arkoubi, A. Y. (2023). Effectiveness and Role of Using Hyaluronic Acid Injections for Gluteal Augmentation: A Comprehensive Systematic Review of Techniques and Outcomes. Aesthetic Plastic Surgery, 47(6), 2719–2733. https://doi.org/10.1007/s00266-023-03458-0}

_{[5] Fundarò, S. P., Salti, G., Malgapo, D. M. H., & Innocenti, S. (2022). The Rheology and Physicochemical Characteristics of Hyaluronic Acid Fillers: Their Clinical Implications. International Journal of Molecular Sciences, 23(18), 10518. https://doi.org/10.3390/ijms231810518}

_{[6] Crabai, P., Marchetti, F., Santacatterina, F., Fontenete, S., & Galera, T. (2024b). Nonsurgical Gluteal Volume Correction with Hyaluronic Acid: A Retrospective Study to Assess Long-term Safety and Efficacy. Plastic and Reconstructive Surgery. Global Open, 12(5), e5792. https://doi.org/10.1097/gox.0000000000005792}

_{[7] Kerscher, M., Bayrhammer, J., & Reuther, T. (2008). Rejuvenating Influence of a Stabilized Hyaluronic Acid–Based Gel of Nonanimal Origin on Facial Skin Aging. Dermatologic Surgery, 34(5), 720–726. https://doi.org/10.1111/j.1524-4725.2008.34176.x}

_{[8] Crabai, P., Marchetti, F., Santacatterina, F., Fontenete, S., & Galera, T. (2024). Nonsurgical Gluteal Volume Correction with Hyaluronic Acid: A Retrospective Study to Assess Long-term Safety and Efficacy. Plastic and Reconstructive Surgery. Global Open, 12(5), e5792. https://doi.org/10.1097/gox.0000000000005792}

_{[9] Kazmouz, S. G., Riccio, C. A., Patel, K., Haran, O., & Shifrin, D. (2024). Implant-Based Gluteal Augmentation: Comparing Complications Between Single- and Double-Incision Techniques. Aesthetic Plastic Surgery. https://doi.org/10.1007/s00266-024-04130-x}

_{[10] Santorelli, A., Cerullo, F., Salti, G., & Avvedimento, S. (2022). Gluteal Augmentation with Hyaluronic Acid Filler: A Retrospective Analysis Using the BODY-Q Scale. Aesthetic Plastic Surgery, 47(3), 1175–1181. https://doi.org/10.1007/s00266-022-03166-1}

_{[101 De Meyere, B., Mir-Mir, S., Peñas, J., Camenisch, C. C., & Hedén, P. (2014). Stabilized Hyaluronic Acid Gel for Volume Restoration and Contouring of the Buttocks: 24-Month Efficacy and Safety. Aesthetic Plastic Surgery. https://doi.org/10.1007/s00266-013-0251-9}

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