Results and long-term patient satisfaction after gluteal
augmentation with platelet-rich plasma-enriched
Joep C. N. Willemsen
Hieronymus P. J. D. Stevens
Received: 2 May 2013 /Accepted: 7 August 2013 /Published online: 1 September 2013
Springer-Verlag Berlin Heidelberg 2013
Background Buttock augmentation is gaining increasing pop-
ularity in aesthetic surgery. The relatively high incidence of
complications after silicone implant placement lead to the
increased use of lipofilling techniques, yielding variable re-
sults with respect to graft take rate and long-term stability.
Platelet-rich plasma (PRP) has been shown to have beneficial
effects on wound healing and angiogenesis in the past. There-
fore, we aimed at investigating the long-term results and
patient satisfaction after PRP-enriched lipofilling for buttock
Methods Twenty-four bilateral gluteal augmentations with
PRP-enriched autologous fat were performed. Additionally,
contour shaping was achieved by liposuction of the adjacent
zones. Post-operative results and complications were
recorded, and satisfaction with buttock shape was estimated
by a patient questionnaire.
Results Mean follow-up time was 44 months, and mean
amount of transferred fat was 481 cc for both sides. No seroma
or hematoma formation, infection or liponecrosis were report-
ed during the post-operative follow-up. Subjective patient
satisfaction in general increased from preoperatively to
3 months postoperatively and declined only slightly in the
long-term course. Satisfaction levels in general were specific
for each patient. Patient recovery was quick, and the majority
of patients returned to work within 10 days after surgery.
Conclusions PRP-enhanced lipofilling of the buttocks proved
to be a safe procedure including a low complication rate and
consistent results. However, subjective patient expectations
have to be taken into account when choosing the indication.
Further large volume studies are needed to elucidate the
potential and benefit of PRP in this context.
Level of Evidence: Level IV, therapeutic study.
Over the past decades, the demand for a better definition of the
body and the buttock area has been increasing .
Augmenting the buttocks by placement of implants represents
a commonly used technique. The relatively high incidence of
implant-related complications, e.g. infection, malpositioning,
nerve compression, wound healing problems or unnatural
aesthetic appearance, lead to the quest for alternative tech-
niques . In the 1980s, liposuction was introduced, making
fat asservation and reinjection to correct contour irregularities
possible, and subsequently, buttock augmentation by
lipofilling was performed [3, 4]. The effect on lower body
contouring was even improved by the combination of gluteal
lipofilling and liposuction of the adjacent areas of lower back
and thighs .
One drawback of this procedure is that it may have to be
repeated several times to achieve the desired result due to fat
resorption, leading to increased costs and risks for the patients.
On the other hand, injecting too large volumes of fat may result
in an increase of complications, such as seroma formation,
liponecrosis, infection and fat embolism syndrome [2, 4].
Therefore, efforts to improve fat graft take have to be made.
One approach is the addition of previously prepared adipose-
derived stem cells (ADSCs) to the fat graft, which is referred to
Joep C.N. Willemsen and Nicole Lindenblatt contributed equally to the
J. C. N. Willemsen
H. P. J. D. Stevens
Bergman Clinics The Hague, Binckhorstlaan 149, 2516 BA The
Hague, The Netherlands
N. Lindenblatt (*)
Division of Plastic and Hand Surgery, Department of Surgery,
University Hospital Zurich, Raemistrasse 100, 8091 Zürich,
Eur J Plast Surg (2013) 36:777–782