A newly published scoping review maps the evidence behind buttock augmentation and emphasizes that procedure selection and injection plane remain central to safety.
A new buttock surgery safety review published on 30 October 2026 reinforces the importance of anatomical planning, careful patient selection and subcutaneous-only fat grafting with ultrasound visualization. The findings come from a scoping review of surgical and nonsurgical approaches to gluteal contouring, rather than a new clinical trial.
What evidence did the researchers examine?
Researchers based in Brazil searched PubMed and Embase for literature available through June 2025. They identified 938 records and included 44 sources in their final evidence map. The material ranged from anatomical studies and technical reports to case series, reviews and safety recommendations.
Because these studies used different methods and measured different outcomes, the authors did not treat the collection as a single pooled trial. A scoping review is designed to map what evidence exists, identify areas of agreement and expose gaps that need better research.
Why does the fat-injection plane matter?
Gluteal fat grafting can produce serious complications when fat is introduced into unsafe deep planes. The review emphasizes maintaining fat placement within subcutaneous tissue and using ultrasound visualization to strengthen control of the injection plane. This approach reflects contemporary safety guidance developed in response to fatal fat embolism events.
Ultrasound is an aid to anatomical visualization, not a guarantee of safety. Appropriate surgical training, operating conditions, patient selection and adherence to accepted protocols remain essential.
What about implants and fillers?
The review found that aggregate complication rates for fat grafting were lower than for implants in comparative reviews, but that comparison must be interpreted cautiously because patients, techniques and follow-up periods differ. Fat grafting also retains potentially catastrophic risks when performed incorrectly.
For implants, the authors could not establish clear superiority between certain muscular placement planes. Evidence for injectable fillers and several alternative lifting or flap techniques was limited and heterogeneous. A lack of strong comparative data should not be mistaken for proof that an approach is either safe or ineffective.
What should patients take from the findings?
The paper does not recommend a single gluteal contouring procedure for everyone. Anatomy, medical history, desired changes and the likely risks of each technique need to guide consultation. The authors call for standardized outcome measures and higher-quality comparative studies.
The strongest message is about safety culture. A technically achievable cosmetic change is not automatically an appropriate operation, and procedural decisions should be based on more than the promise of volume or contour. The review contributes to the evidence base but cannot provide an individual patient risk estimate.
The authors’ review also underscores the difficulty of comparing cosmetic outcomes between techniques. Satisfaction, contour, revision procedures and major complications are not always defined or followed up consistently. Without shared outcome definitions, even large collections of published reports can leave important clinical questions unresolved. This makes transparent counseling and careful documentation especially important. It also reinforces the need to report major complications and follow patients long enough to capture outcomes beyond the immediate postoperative period.
Original source: Gonçalves FGA et al. Buttock Surgery: Key Insights, Challenges, and Best Practices—A Scoping Review. Aesthetic Plastic Surgery. Published 30 October 2026. Open original source
DOI: 10.1007/s00266-026-06389-8
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