Aesthetic Augmentation of the Trochanteric Gluteal Region in Patients with Gender Dysphoria: Lipoinjection, Gluteal Implants, and Hip Implants

Abstract

Background: One of the surgical procedures most requested by patients with gender dysphoria is gluteus-trochanteric improvement, and there are few scientific reports on managing this region. We present our 14-year surgical experience combining different surgical procedures for trochanteric gluteal improvement in patients with gender dysphoria. Methods: From October 2007 to December 2022, patients with male-to-female gender dysphoria who requested feminization of the trochanteric gluteal region were operated on, undergoing combined liposuction, lipoinjection, and gluteal (GI) and hip implant (HI) placement. Results: One hundred seventy-two patients aged between 23 and 56 years (mean: 36.4 years) were included, with follow-up from 3 to 45 months (mean: 26 years). Lipoinjection alone was performed on buttocks and hips in 132 patients (76.7%), GIs plus hip lipoinjection were performed in 22 patients (12.7%), and 18 patients (10.4%) underwent GIs and HIs. Lipoinjection was added to eight patients in this last group. The overall satisfaction in all groups was 89%. The main reason for dissatisfaction was volume loss secondary to fat reabsorption (8%). There were no significant complications, with the most common adverse events being HI displacement in two of 18 patients (11.11%) and wound dehiscence secondary to GI placement in four of 40 patients (10%). Conclusion: With the appropriate combination of liposuction, lipoinjection, GIs, and HIs, it is possible to feminize the trochanteric gluteal region with highly satisfactory results.