Prosopoplasty: A New Term?

is gluteal autoaugmentation. Most articles focusing on the buttock region in a massive weight loss patient propose some form of auto-augmentation by using the surplus tissue. However, in a certain type of patient, this form of augmentation may not be possible due to the pronounced weight loss with lacking tissue volume. Additionally, creating flaps and burying them subcutaneously can also lead to problems such as tissue palpability, partial fat tissue necrosis, or loss of volume. However, buttock autoaugmentation should always be considered the first option in this patient population (Fig. 3). The combination of gluteal implants with a large lifting procedure should be reserved for special cases since this procedure has a definite learning curve and the added morbidity of two procedures. Table 1 lists our algorithmic approach and indications for gluteal reshaping in the massive weight loss patient. In conclusion, we believe that the popularity of buttock procedures will continue to rise following its recent trend. In particular, in the massive weight loss population, in whom a volume depletion of the buttocks is often encountered, strategies for aesthetic correction are in demand. We hope that this algorithmic approach may prove useful in this endeavor. Operative technique Clinical problem/constellation Gluteal autoaugmentation Easiest method without the need for additional operative procedures. Works well in all patients with pronounced tissue deflation but with some remaining subcutaneous tissue. The biggest disadvantage is the need for an extensive excisional procedure with a resulting long scar. Gluteal augmentation with fat Is ideal in patients with not too much skin flaccidity and sufficient fat deposits. Advantages include concomitant liposuction to improve body contour and minimal scars in the gluteal region. Disadvantages include uncertainty of fat retention and the need for an additional operative procedure. Gluteal augmentation with implants Is ideal in patients who do not want obvious scars but have too much skin surplus for fat grafting. Advantages include a permanent result with fixed volume and concealed scars. Disadvantages include the need for an implant with associated costs and prolonged postoperative reconvalescence. Gluteal augmentation with implants and lifting procedure Most extensive approach for gluteal reshaping. Best suited for patients with extensive tissue deflation and sagging. Advantages include its being the most versatile and powerful reshaping procedure. Disadvantages include possible wound healing complications with the risk of implant infection, being the most difficult operative approach, and having the longest postoperative downtime. with silicone implants: a multicenter survey …