Skip to main content
SpringerLink
Log in

Safety and Efficacy Study of the Application of Redensified Cross-Linked Hyaluronic Acid for Filling Gluteal Volume and Cellulite Depressions

  • Original Articles
  • Fat Injection
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

A Correction to this article was published on 11 January 2024

This article has been updated

Abstract

Purpose

To test the efficacy and safety of cross-linked hyaluronic acid application for filling buttocks and cellulite depressions and its permanence over time.

Methods

For a period of a year, 25 patients were applied redensified cross-linked hyaluronic acid in the gluteal area. These patients were all 23–45-year-old women with little fat to be removed. The product used is composed of hyaluronic acid with high cross-linking and redensification which allows it to maintain shape and durability over time. All patients underwent tumescent anesthesia with neuroleptic sedation in the operating room. The procedure was regarded as minimal (container, sterile gloves, and surgical field). The amount applied for gluteal augmentation varied from 50 to 100 ml per application area and according to the patient’s needs. For the filling of cellulite depressions, the application was up to 3 cc per depression and up to a total of 40 ml. The maximum volume used per patient in the buttocks did not exceed 200 ml, and it did not exceed 40 ml in cellulite depressions.

Results

A group of patients was treated in the upper and middle third of the buttocks in superficial and deep subcutaneous layers and in cellulite depressions. Very good results have been obtained without any major complications.

Conclusions

The use of redensified cross-linked hyaluronic acid of non-animal origin is therefore an option for gluteal augmentation and cellulite depressions. Although the product degrades over time, after 12 months, 44% of treated patients rated their results as highly or very much improved, 36% as improved, 16% rated the improvement as poor, and one patient (4%) was dissatisfied.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Change history

References

  1. Babuccu O, Gozil R, Ozmen S, Bahcelioglu M, Latifoglu O, Celebi MC (2002) Morphology of the gluteal region: the effect of weight gain and aging. Aesthet Plast Surg 26:130–133

    Article  Google Scholar 

  2. Bruner TW, Roberts TL III, Nguyen K (2006) Complications of buttocks augmentations: diagnosis, management, and prevention. Clin Plast Surg 33:449–466

    Article  PubMed  Google Scholar 

  3. Bucky LP, Percec I (2008) The science of autologous fat grafting: views on current and future approaches to neoadipogenesis. Aesthet Surg J 28:313–321

    Article  PubMed  Google Scholar 

  4. Camenisch CC, Tengvar M, Hedén P (2013) Macrolane for volume restoration and contouring of the buttocks. magnetic resonance imaging study on localization and degradation. Plast Reconstr Surg 132:522e–529e

    Article  CAS  PubMed  Google Scholar 

  5. De Meniere B, Mir-Mir S, Pena J, Camenisch CC et al. Stabilized Hyaluronic Acid gel for volumenization and contouring the buttocks. www.clinicaltrial.gov.

  6. Cardenas Restrepo JC, Munoz Ahmed JA (2002) Large volume lipoinjection for gluteal augmentation. Aesthet Surg J 22:3–38

    Google Scholar 

  7. Pigneur C, Domergue F, Than Trong E, Bosc R, Meningaud J, Lantieri L (2011) Morphological and functional evaluation of the treatment of gluteal lipoatrophy with stabilized gel based on hyaluronic acid of non-animal origin: 6 months efficacy and safety results. Presented at the World Anti-Aging Congress, Montecarlo. 24–26 Mar 2011

  8. Wang F, Garza LA, Kang S et al (2007) In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol 143(2):155–163. https://doi.org/10.1001/archderm.143.2.155

    Article  CAS  PubMed  Google Scholar 

  9. Cornejo P, Alcolea JM, Trelles MA (2011) Ibero-Latin Am Plast Surg 37(4):393–402

    Google Scholar 

  10. Falcone SJ, Berg RA (2008) Crosslinked hyaluronic acid dermal fillers: a comparison of rheological properties. J Biomed Mater Res A 87(1):264–271. https://doi.org/10.1002/jbm.a.31675

    Article  CAS  PubMed  Google Scholar 

  11. Lourenço LM, de Noronha MGO, Colla LA, Izzo TR, Sigrist R, Braz A (2022) LL body contour technique. A new way of gluteal contouring and augmentation with hyaluronic acid filler. J Cosmet Dermatol 21(5):1967–1972. https://doi.org/10.1111/jocd.14763

    Article  PubMed  Google Scholar 

  12. National Aesthetic Surgery Data Bank Statistics 2010. Retrieved Feb 2012 at http://www.surgery.org/sites/default/ files / Stats 2010_1.pdf.

  13. Xue Y, Chen H, Xu C, Yu D, Xu H, Hu Y (2020) Synthesis of hyaluronic acid hydrogels by crosslinking the mixture of high-molecular-weight hyaluronic acid and low-molecular-weight hyaluronic acid with 1,4-butanediol diglycidyl ether. RSC Adv 2020(12):7206–7213. https://doi.org/10.1039/c9ra09271d.

    Article  CAS  Google Scholar 

  14. De Boulle K, Glogau R, Kono T, Nathan M, Tezel A, Roca-Martinez JX, Paliwal S, Stroumpoulis D (2013) A review of the metabolism of 1,4-butanediol diglycidyl ether-crosslinked hyaluronic acid dermal fillers. Dermatol Surg 39(12):1758–1766. https://doi.org/10.1111/dsu.12301

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Costa AN, Mendes DM, Toufen C, Arrunátegui G, Caruso P, de Carvalho CR (2008) Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. Brazilian Journal of Pulmonology 34:622–625

    Google Scholar 

  16. de Pedroza L (2000) Fat transplantation to the buttocks and legs for aesthetic enhancement or correction of deformities: ling-term results of large volumes of fat transplant. Dermatol Surg 26:1145–1149

    Article  PubMed  Google Scholar 

  17. Dover JS, Rubin MG, Bhatia AC (2009) Review of the efficacy, durability, and safety data of two non-animal stabilized hyaluronic acid fillers from a prospective, randomized, comparative multicenter study. Dermatol Surg 35(Supplement 1):322–330

    Article  CAS  PubMed  Google Scholar 

  18. Eremia S, Newman N (2000) Long-term follow-up after autologous fat grafting: analysis of results from 116 patients followed at least 12 months after receiving the last of a minimum of two treatments. Dermatol Surg 26:1150–1158

    Article  CAS  PubMed  Google Scholar 

  19. Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S-120S

    Article  CAS  PubMed  Google Scholar 

  20. Glogau RG, Kane MA (2008) Effect of injection techniques on the rate of local adverse events in patients implanted with non-animal hyaluronic acid gel dermal fillers. Dermatol Surg 34(Supplement 1):S105–S109

    CAS  PubMed  Google Scholar 

  21. Hamilton RG, Strobos J, Adkinson NF Jr (2007) Immunogenicity studies of cosmetically administered non-animal stabilized hyaluronic acid particles. Dermatol Surg 33(Supplement 2):S176–S185

    CAS  PubMed  Google Scholar 

  22. Harrison D, Selvaggi G (2007) Gluteal augmentation surgery: indications and surgical management. J Plast Reconstr Aesthet Surg 60:922–928

    Article  PubMed  Google Scholar 

  23. Heden P, Olenius M, Tengvar M (2011) Macrolane for breast enhancement: 12-month follow-up. Plast Reconstr Surg 127:850–860

    Article  CAS  PubMed  Google Scholar 

  24. Heden P, Sellman G, von Wachenfeldt M, Olenius M, Fagrell D (2009) Body shaping and volume restoration: the role of hyaluronic acid. Aesthet Plast Surg 33:274–282

    Article  Google Scholar 

  25. Illouz YG (1983) Body contouring by lipolysis: a 5-year experience with over 3000 cases. Plast Reconstr Surg 72:591–597

    Article  CAS  PubMed  Google Scholar 

  26. Inglefield C (2011) Early clinical experience of hyaluronic acid gel for breast enhancement. J Plast Reconstr Aesthet Surg 64:722–729

    Article  PubMed  Google Scholar 

  27. Kaufman MR, Bradley JP, Dickinson B, Heller JB, Wasson K, O’Hara C, Huang C, Gabbay J, Ghadjar K, Miller TA (2007) Autologous fat transfer national consensus survey: trends in techniques for harvest, preparation, and application, and perception of short-and long-term results. Plast Reconstr Surg 119:323–331

    Article  CAS  PubMed  Google Scholar 

  28. Khan UD (2010) Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration. Aesthet Plast Surg 34:42–47

    Article  Google Scholar 

  29. Lee EI, Roberts TL, Bruner TW (2009) Ethnic considerations in buttock aesthetics. Semin Plast Surg 23:232–243

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lehnhardt M, Homann HH, Daigeler A, Hauser J, Palka P, Steinau HU (2008) Major and lethal complications of liposuction: a review of 73 cases in Germany between 1998 and 2002. Plast Reconstr Surg 121:396e–403e

    Article  PubMed  Google Scholar 

  31. Mendieta CG (2003) Gluteoplasty. Aesthet Surg J 23:441–455

    Article  PubMed  Google Scholar 

  32. Murillo WL (2004) Buttock augmentation: case studies of fat injection monitored by magnetic resonance imaging. Plast Reconstr Surg 114:1606–1614

    Article  PubMed  Google Scholar 

  33. Narins RS, Brandt FS, Lorenc ZP, Maas CS, Monheit GD, Smith SR, McIntyre S (2007) A randomized, multicenter study of the safety and efficacy of dermicol-P35 and non-animal-stabilized hyaluronic acid gel for the correction of nasolabial folds. Dermatol Surg 33(Supplement 2):S213–S221

    CAS  PubMed  Google Scholar 

  34. Nicareta B, Pereira LH, Sterodimas A, Illouz YG (2011) Autologous Gluteal Lipograft. Aesthetic Plast Surg 35:216–224

    Article  PubMed  Google Scholar 

  35. Rietjens M, De Lorenzi F, Rossetto F, Brenelli F, Manconi A, Martella S, Intra M, Venturino M, Lohsiriwat V, Ahmed Y, Petit JY (2011) Safety of fat grafting in secondary breast reconstructions after cancer. J Plast Reconstr Aesthet Surg 64:477–483

    Article  CAS  PubMed  Google Scholar 

  36. Roberts TL III, Weinfeld AB, Bruner TW, Nguyen K (2006) “Universal” and ethnic ideals of beautiful buttocks are best obtained by autologous micro fat grafting and liposuction. Clin Plast Surg 33:371–394

    Article  PubMed  Google Scholar 

  37. Senderoff DM (2011) Buttock augmentation with solid silicone implants. Aesthet Surg J 31:320–327

    Article  PubMed  Google Scholar 

  38. Taylor SC, Burgess CM, Callender VD (2010) Efficacy of nonanimal stabilized hyaluronic acid dermal fillers in patients with skin of color: a randomized, evaluator-blinded comparative trial. Dermatol Surg 36:741–749

    Article  CAS  Google Scholar 

  39. Taylor SC, Burgess CM, Callender VD (2009) Safety in nonanimal stabilized hyaluronic acid dermal filler in patients with skin of color: a randomized evaluator-blinded comparative trial. Dermatol Surg 35(Supplement 2):1653–1660

    Article  CAS  PubMed  Google Scholar 

  40. Avantaggiato A, Girardi A, Palmieri A, Pascali M, Carinci F (2015) Biorevitalization: effects of NASHA on genes involving tissue remodeling. Aesth Plast Surg 39(4):459–464. https://doi.org/10.1007/s00266-015-0514-8

    Article  CAS  Google Scholar 

  41. Rosique S et al (2018) Augmentation gluteoplasty: a Brazilian perspective. PRS 142:910–919

    CAS  Google Scholar 

  42. Santorelli S et al (2023) Effectiveness and role of using hyaluronic acid injections for gluteal augmentation APS 47:1175–1181 and the commentary by Hsieh and Wong. APS 47:1182–1184

    Google Scholar 

  43. Mortada A et al (2023) Effectiveness and role of using hyaluronic acid injections for gluteal augmentation. APS. https://doi.org/10.1007/s00266-023-03458-0

    Article  Google Scholar 

  44. Avendano-Valenzuela G (2010) Contouring of gluteal region. Current concepts and proposal for classification. Cirugía Plástica Iberolatinoamericana 36(3):239–245

    Google Scholar 

  45. Aslani DV (2019) Composite buttock augmentation: the next frontier in gluteal surgery. PRS 144:1312–1321

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Plastic Surgery & Laser Department, Clínica Robles, 2530 Virrey del Pino St, C1426EGT, Autonomous City of Buenos Aires, Buenos Aires, Argentina

    Marcelo F. Robles

Authors
  1. Marcelo F. Robles
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcelo F. Robles.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with animals performed by any of the authors, but it does contain studies performed with human participants.

Informed Consent

For this type of study, informed consent was required and obtained from patients.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robles, M.F. Safety and Efficacy Study of the Application of Redensified Cross-Linked Hyaluronic Acid for Filling Gluteal Volume and Cellulite Depressions. Aesth Plast Surg 48, 1181–1192 (2024). https://doi.org/10.1007/s00266-023-03739-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-023-03739-8

Keywords

Search

Navigation