(2 mm) specifically for contouring superficial body fat, the configuration of which (number of open ports) is determined by the type and the degree of gluteal correction to be realized. to sculpt rounded contours to square-shaped buttocks muscles, superficial liposculpture allows the plastic surgeon to control the injection-rate of the fat-volume. moreover, superficial liposuction can be combined with other treatment methods for contouring the gluteal region to achieve the required functional, anatomic correction, and the aesthetic enhancement sought by the patient, such as reshaping the lateral area of the buttocks into an athletic form. the study contouring the gluteal region with tumescent liposculpture (2011) indicated that effective, gluteal-region contouring is best achieved by tailoring the liposuction-reduction and the lipoinjection-augmentation techniques to the anatomic topography of the body areas to be corrected. furthermore, the study contouring of the gluteal region in women: enhancement and augmentation (2011) indicated that natural contours of the buttocks and the thighs are effectively achieved with a combined gluteoplasty of selective liposuction and lipoinjection, which reduces the need for aggressive surgical procedures, decreases the risk of medical complications, abbreviates wound-recovery-time, and lessens post-operative scarring. combined with any buttocks-correction method, superficial liposculpture facilitates the treatment of contour irregularities, the surgical revision of scars, and the correction of gluteal-region contour depressions. surgical technique pre-operative matters to meet the functional requirements and the aesthetic expectations (body image) of the patient, the plastic surgeon establishes a realistic and feasible surgery plan by which to correct the anatomic contour deficiencies of the gluteal region. the surgeon and the patient determine the location of the surgical-wound scars, and determine the best operative position, to allow the proper exposure of the pertinent anatomy to be corrected. because the surgical procedure requires the tumescence and anaesthesia of the gluteal-region area to be corrected, the physician and the anaesthesiologist determine the volumes of the anaesthetic and tumescent fluids to be administered to the patient during the procedure, and so avoid the risks of drugs overdose and toxicity. intra-operative matters once the patient is atop the operating table, the surgeon positions him or her to best expose the pertinent gluteal-region area that is to be corrected or contoured, or both; the usual operative position is the prone (face down) position, but the patient can also be positioned laterally (on his or her side). the surgical correction plan can be delineated and marked to the patient's body when he or she is awake (before sedation or anaesthesia) or it can be delineated when the patient is on the operating table (already sedated or anaesthetized). in operative praxis, the second option allows the plastic surgeon greater freedom to properly manipulate the patient into the position best suited for performing the body-contouring surgery. operative matters once the patient is in the operative position, the surgeon begins the liposuction correction by making incisions to the marks of the surgical-correction plan, and then infiltrates (injects) a solution of anaesthesia- and tumescence-inducing drugs, usually a combination of lidocaine and epinephrine. the volume of the anaesthetic-tumescent solution is gradually infiltrated to the pertinent gluteal area, in order to avoid the nerves and the deeper anatomic structures of the gluteus maximus muscle. the particular anatomic features to be contoured determine the types of cannula (gauge, size, grade) used to effect and control the harvesting of excess adipose fat from the patient's body. for a lipoinjection augmentation, the surgeon first dissects and prepares the augmentation-pocket to which will be injected the autologous fat-tissue. the surgical creation (muscle dissection) of the augmentation-pocket avoids the gluteal innervation (superior gluteal nerve and inferior gluteal nerve) and the vascular system (venous and arterial) of the gluteus maximus muscle. afterwards, the surgeon sutures the dissection-incision and secures it with adhesive tape to ensure that the augmentation-pocket remains open, as dissected, ready to receive the injections of adipose fat. for the revision of scars, with surgery and injections of autologous fat, or with allopathic synthetic fillers, the surgeon applies subcuticular closures to the incision wounds, which then are bandaged. post-operative matters after completing the surgical corrections and the lipoinjection contouring of the pertinent area(s) of the gluteal region, the surgeon thoroughly examines the patient to ensure his or her general recovery from the operation; and examines each surgical incision to ascertain that it is correctly sutured and taped, in order to facilitate the uneventful healing of the gluteus-muscle tissues, without medical complications. the patient is advised to avoid exercise and strenuous physical activity until 3-weeks post-operative; how to properly care for surgical-incision wounds; and how to wear a compression garment that will keep in place the surgically corrected tissues, and so ensure their healing as a whole anatomic unit of the gluteal region. follow-up and convalescence the physician advises the patient who has undergone a surgical contouring of the buttocks with gluteal implants, that, although immediate results can be observed, the final, corrected body contour usually is observed at 6-months post-operative, and at 1-year post-operative, depending upon the tissue-healing capabilities of the patient's body. the liposculpture patient usually requires approximately 6 months, and occasionally 1 year before producing the final, corrected body contour. for both procedures, at approximately 1-month post-operative, marked aesthetic improvement is noticeable in the corrected body areas, as is the elimination of the initial, post-operative weight gain caused by the body's retention of the infiltrated, anaesthetic and tumescent, fluids. the patient is advised to wear a compression garment to contain swelling and to immobilize the corrected tissues, so that they heal as one anatomic unit of the gluteal region. moreover, throughout the convalescence, to facilitate shrinking the skin to the new, corrected body contour, and to resolve unevenness, wrinkles to the skin, and localized swelling, the continual application of massage and (occasional) ultrasound treatments can facilitate the diminishment of the post-operative conditions. complications the surgical and liposculpture contouring of the human body presents possible medical complications such as: the psychological—unmet body image expectations of aesthetic improvement; the physical—uneven contour, local and general; the physiologic—toxic reactions to the anaesthesic and the tumescent drugs; and the nervous—paresthesia, localized areas of perduring numbness in the corrected portion(s) of the gluteal region. the medical complications possible to a surgical buttocks augmentation procedure, the submuscular emplacement of a gluteal implant, include infection, surgical-wound dehiscence that exposes the implant, revision surgery, rupture of the implant, seroma (a pocket of clear serous fluid), capsular contracture, asymmetry of the corrected area, shifting of the implant, surgical over-correction, injury to the sciatic nerve, and paresthesia (tingling skin). the medical complications possible to a liposculpture buttocks augmentation include the bodily resorption of some of the injected adipose fat, asymmetric contour of the corrected body area, an irregular contour to the body, seroma, abscess (pus enclosed by inflamed tissue), cellulitis (subcutaneous connective-tissue inflammation), and paresthesia. dangers like most medical procedures, buttock augmentation come with risks some of which can be life-threatening. a total of 413 mexican plastic surgeons reported 64 deaths related to liposuction, with 13 deaths caused by gluteal lipoinjection. in colombia, nine deaths were documented. of the 13 deaths in mexico, eight (61.6 percent) occurred during lipoinjection, whereas the remaining five (38.4 percent) occurred within the first 24 hours. in colombia, six deaths (77.7 percent) occurred during surgery and three occurred (22.2 percent) immediately after surgery. secondary lymphoedema of the lower extremities has been reported as an unusual side effect of liquid silicone injection on the hips and buttock while thromboembolism, implant displacement and explosion has also been listed as some of the dangers. unmet expectations in the surgical praxis of body contouring therapy, the patient's body-image expectations can be different from the contoured body that is the outcome of the performed surgical operation. such unmet aesthetic expectations can be avoided at the pre-operative consultation stage, whereby, with informed consent, the physician and the patient jointly establish a realistic and feasible surgery plan to achieve a mutually satisfactory corrective outcome (functional and aesthetic) of the operation to the gluteal region, the buttock- and thigh-areas. contour problems contour problems of the corrected gluteal region can be prevented with the operational use of small-gauge cannulas (ca. 2.0 mm) specifically for superficial liposuction; and with the application of cross-pattern harvesting of the excess body fat, to avoid removing too much adipose fat tissue, which might disfigure the contour of the patient's fat-donor area. the possible contour problems that might arise from ultrasonic liposuction are skin burns and hypertrophic scarring, which might occur if the fat-donor area skin is not cooled and protected during the fat harvest. to that end, the infusion of a tumescence-inducing solution to the fat-donor area(s) assists in cooling the patient's skin during the ultrasonic lipo-harvesting; likewise, the application of moist towels, a skin protector, and the constant cooling-fluid infiltration of the cannula in an integrated sheath. drug complications (anaesthetic and tumescent) the infiltration of a solution of anaesthesia- and tumescence-inducing drugs can present medical complications such as a fluid overload of the tissues, the inadequate replacement of the infiltrated solution, and the partitioning (separation) of a single infiltration into several pools, which then are removed by suction lipectomy. moreover, during anaesthesia, maintaining the patient's stable blood pressure can be difficult, which increases the possibility of bleeding, and the possibility that anaesthetic toxicity can occur if excessive doses are administered by infiltration; the symptoms are manifested as central nervous system (cns) occurrences of drug-induced anxiety, apprehension, restlessness, nervousness, disorientation, confusion, dizziness, blurred vision, tremors, nausea, vomiting, shivering, and seizures; likewise, as manifestations of drowsiness, unconsciousness, respiratory depression, and respiratory arrest. furthermore, the toxicity symptoms of a tumescence-inducing drug (e.g. epinephrine) might cause such cns symptoms, for which reason the operative application of a tumescent drug is limited throughout the operation. numbness (paresthesia) post-operatively, local areas of numbness (paresthesia) might occur in the contoured portion(s) of the gluteal region, and might perdure for a long time after the surgery. hence, the patient is advised to facilitate the re-sensitizing of the numb area(s) with applications of gentle massage, to prevent the development of a neuroma complication, and to alleviate pain. nonetheless, depending upon the tissue-healing capabilities of the patient, he or she can recover in full at 2-years post-operative. outcome the outcome of a buttocks-contouring procedure depends upon the specific defect or deformity that can be effectively corrected with liposculpture, ultrasonic or not. nonetheless, depressed scars and deep morphological defects are difficult to correct because of the curvature of the buttocks as an anatomic unit, and because of the scar-contracting elements of the tissues across the gluteal curvature. in such a case, although the injection of (autologous or artificial) tissue fillers to correct the defect or the deformity might be impermanent—it usually will remedy the functional and aesthetic shortcoming(s) required by the patient, which is the therapeutic purpose of gluteoplasty. non-surgical procedures while surgical buttock enhancements are popular, there are minimally invasive alternatives. one such alternative is sculptra, which is an injectable solution made of poly-l-lactic acid particles. by stimulating the body's own collagen production, the injected area begins to expand over the course of 1 - 2 months.