“Brazilian Butt Lift Gone BAD” Necrotizing Soft Tissue Infection After Gluteal Augmentation: Review Of Two Cases

摘要

Gluteal augmentation or the “Brazilian Butt Lift” is a surgical procedure used to improve the cosmetic appearance of the buttocks. Most references regarding this procedure emphasize its benefit but minimize the risk of the operation. In this manuscript, we report an experience treating two patients who experienced severe soft tissue infection following these operations. Background Liposuction is currently the most popular body contouring technique. Aesthetic gluteal augmentation by lipo-injection is an increasingly popular method of gluteal augmentation. The surgical procedure encompasses liposuction of the hips, thighs and abdomen followed by injection of autologous fat intramuscularly as well as in the subcutaneous plane. This method of gluteal augmentation is believed to have several advantages over silicone implants as 1) it is believed to be a less invasive procedure 2) enables a large volume augmentation and 3) eliminates the danger of implant rupture. It also has the theoretical advantage of reducing fat in other parts of the body. However, we report two cases of severe necrotizing soft tissue infection after gluteal augmentation with lipo-injection. Methods We report two patients who underwent lipo-assisted gluteal augmentation who presented with severe necrotizing soft tissue infection. Results The first patient was a 23-year-old woman who underwent gluteal augmentation in Mexico. Seven days after her augmentation procedure, she presented to our hospital with severe dehydration, fever and a picture of sepsis. Her temperature was 39.4°C. Blood pressure was 90/53 mmHg and pulse was 120. When an MRI scan (Figure 1) demonstrated a nearly 6cm abscess in the left gluteal region, a surgical consultation was requested. After resuscitation and initiation of antibiotic therapy, she underwent extensive incision, drainage and debridement of the gluteal region. Foul smelling fluid was drained. Wound cultures were positive for Bacteroides and Candida. She returned to the operating room several more times for dressing changes and further debridement. She was also treated with appropriate antimicrobial therapy and aggressive local wound care and she was discharged after two weeks. Her wound healed secondarily.