Elahi Leslie, Ulrich Franzisca, Raffoul Wassim, Rossi Severin Alexander
Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Aesthet Surg J Open Forum. 2022 Jun 20;4:ojac051. doi: 10.1093/asjof/ojac051. eCollection 2022.
Buttock augmentation is a commonly performed aesthetic surgery. Several methods have been described, but only the use of implants or autologous fat is consensually deemed safe and effective. Synthetic fillers in gluteal augmentation have been described despite potential severe long-term complications, both medical and aesthetic. The aim of this study is to report a series of 2 consecutive cases who underwent buttock and hip augmentation with large volumes of permanent copolyamide filler requiring surgical removal due to significant complications. Based on these cases and a review of recent literature, a management algorithm is proposed. The authors conducted a retrospective chart review of 2 consecutive cases of failed copolyamide filler augmentations in the gluteal and inguinal regions. The authors conducted a literature overview using PubMed (National Institutes of Health, Bethesda, MD) and Google Scholar (Google, Mountain View, CA) to include all articles concerning the removal of large quantities of permanent copolyamide fillers. Based on the physical properties of copolyamide, resection of the filler was performed by percutaneous aspiration with liposuction cannulas, with varying infiltration protocols. Both cases showed successful removal of major parts of the filler; however, residual material tended toward migration, requiring a secondary intervention. Hydrated low-pressure aspiration can manage nonintegrated gluteal copolyamide filler but will achieve only partial resection. Literature shows that radical excision is possible, however, with major drawbacks in function and aesthetics. Moreover, in acute inflammation and infection, an open approach should be preferred.
臀部增大术是一种常见的美容手术。已经描述了几种方法，但只有使用植入物或自体脂肪被一致认为是安全有效的。尽管存在潜在的严重长期并发症，包括医学和美学方面的，臀肌增大术中仍使用了合成填充剂。本研究的目的是报告连续2例因严重并发症而需要手术取出大量永久性共聚酰胺填充剂进行臀部和髋部增大术的病例。基于这些病例并回顾近期文献，提出了一种管理算法。作者对连续2例臀肌和腹股沟区共聚酰胺填充剂植入失败的病例进行了回顾性图表分析。作者使用PubMed（美国国立卫生研究院，马里兰州贝塞斯达）和谷歌学术（谷歌，加利福尼亚州山景城）进行了文献综述，以纳入所有关于取出大量永久性共聚酰胺填充剂的文章。根据共聚酰胺的物理特性，使用吸脂套管针通过经皮抽吸进行填充剂切除，采用不同的浸润方案。两例均成功取出大部分填充剂；然而，残留物质有迁移倾向，需要二次干预。水合低压抽吸可处理未整合的臀部共聚酰胺填充剂，但只能部分切除。文献表明，根治性切除是可行的，然而，在功能和美学方面存在主要缺点。此外，在急性炎症和感染时，应首选开放手术方法。
