Marc R. Matthews, Emily A. Helmick, Daniel M. Caruso and Kevin N. Foster
Introduction: The Brazilian Butt Lift is an increasingly popular procedure that alters the appearance of the buttocks. Surgical infections range from 1.9% to 5% of the total complication rate for gluteal augmentation, including both superficial and deep infections. We present an uncommon case of necrotizing soft tissue infection after gluteal augmentation requiring multiple debridements.
Methods/Results: A 30 year-old male presented with a twenty-four hour history of buttock pain having undergone a bilateral gluteal implant procedure twelve days prior. After a clinical work-up he was immediately taken to the operating theatre for removal of the bilateral buttock implants and debridement of the necrotic subcutaneous tissue, fascia and muscles of the bilateral buttocks. Large counter incisions were made on the buttocks for removal of the implants and packing of the wounds with dressings. During his hospital course he required 16 bilateral buttock soft tissue debridements and several more involving an abscess to the left posterior thigh that tracked distally from the initial buttock infection. The superior gluteal and left thigh wounds were eventually closed with either delayed primary closure or split thickness skin grafting and discharged forty-eight days after presentation.
Conclusions: Recent fades in aesthetic surgery have led to increases in gluteal augmentation, however, infectious complications have been rarely reported as this procedure has an inherently low infectious risk profile. Standard perioperative and postoperative care is essential and early diagnosis of a soft tissue necrotizing infection coupled with prompt surgical intervention, including removal of such prosthetic implants and debridement is mandatory.