Hyaluronic Acid Gluteal Augmentation: New Marking and Application Technique

Background: Current practices in gluteal augmentation with hyaluronic acid (HA) lack standardization. In this study, we propose a novel technique for volume assessment, marking, and the application of HA gluteal augmentation, focusing on achieving optimal results with minimal injection volume. Methods: Twenty-six women received HA injections guided by markings based on anatomical landmarks and desired aesthetics. A laser level and specific points were used to define an ovoid-shaped base with 3 key areas (areas I, II, and III) for targeted HA distribution. A maximum volume of 100 mL (average 40.4 mL) was used for each patient. Results: Hip circumference increased slightly after treatment. Immediately after HA application, the average increases in hip circumference at and 2 cm above the symphysis pubis level were 1.1 and 2.2 cm, respectively. Danilla D point increased by 1.7 cm immediately and by 2.6 cm at 1 month posttreatment. These changes were statistically significant (hip circumference: χ² = 51.1, P < 0.05; Danilla D point: χ² = 47.60, P < 0.05). We evaluated the reproducibility and teachability of the HA gluteal augmentation technique using a questionnaire (LEARN-Q HAGA) in which most participants reported a high degree of confidence and competence in performing the technique. Additionally, the desired aesthetic outcomes and patient satisfaction were evaluated using the GLUTEUS-Q questionnaire. Conclusions: This standardized marking and application technique addressed the limited HA volume by strategically targeting specific gluteal regions. This approach aims to achieve optimal buttock augmentation with minimal complications.