Review Aesthetic

Aesthetic Plastic Surgery

, Volume 37, Issue 2, pp 240-245

First online:

Surgical Pocket Location for Gluteal Implants: A Systematic Review

  • Gerardo Flores-LimaAffiliated withClínica Gerardo Flores-Lima, Hospital de Diagnostico de El Salvador Email author 
  • , Barry L. EppleyAffiliated withIndiana University Health North Hospital
  • , Joaquín R. DimasAffiliated withUniversidad Centro Americana José Simeon Cañas, Boulevard de Los Proceres
  • , David E. NavarroAffiliated withUniversidad Centro Americana José Simeon Cañas, Boulevard de Los Proceres

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The safest pocket location for gluteal augmentation surgery using implants still is unknown. This study conducted a systematic review to derive evidence-based recommendations concerning the safest type of pocket location (sub-muscular, subfascial, intramuscular, or intramuscular XYZ method) for silicone implants in terms of acute and long-term complication rates.


Articles from medline that met predetermined criteria were included in the study. The outcomes of interest included wound dehiscence, wound infection, seroma, hematoma, implant asymmetry, and capsular contracture. Pooling of statistical data was performed when possible.


The authors reviewed 30 articles regarding five different types of pocket locations for gluteal implants described since 1969. The most common complications after gluteal augmentation surgery using implants are wound dehiscence (10.29 %), seroma (2.49 %), wound infection (1.12 %), and hematoma (0.24 %). Fulfilled expectations after surgery were assessed differently among studies and could not be compared.


The pocket locations for gluteal augmentation surgery with implants that have the lowest complication rates are the following: intramuscular XZY method (13.18 %), sub-muscular (17.60 %), intramuscular (18.05 %), and subfascial (54.84 %).

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.


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