体积恢复和臀区外观的增强现在已经成为普遍关注的问题,特别是对于许多女性而言。有几个选项可用,然而,没有一个没有并发症和副作用。使用臀区软组织填充物的体积增强正在成为一种极具吸引力的微创方式。不幸的是,这导致了更多的无证,非医疗从业者以相对较低的成本非法注射臀部。
为了确定安全性,功效,以及大多数用于臀部增强的软组织填充物的成本效益,对PubMed进行系统的文献检索,Medline,和Embase进行,以确定最常用的填充剂用于臀肌增强。通过分别搜索每种确定的填充材料以检索任何遗漏的报告来补充。临床研究和试验的参考文献,reviews,和共识报告也为同一目标进行了审查。
在最终分析12中,大多数强烈偏见的临床报告提供了低水平的证据,被确定列入审查。两项研究涉及聚甲基丙烯酸甲酯(PMMA),5聚L-乳酸,1钙羟基磷灰石和4透明质酸填充剂注射。没有发现涉及液体硅酮或聚丙烯酰胺水凝胶的研究。这项审查提供的几乎没有证据表明,巴西的特定品牌PMMA具有明显的相对良好的安全性,效率,和成本效益记录优于手术异体臀肌增强或只有在专家注射时的脂肪填充。
使用软组织填充物进行的臀肌增强并不像广告中所说的那么简单和无害。可能发生严重的并发症。此外,最佳的臀部轮廓不仅需要增加体积,还需要去除体积;因此,用软组织填充物增加体积可能并不理想。推广这种方式也必须非常小心。确实会发生严重的并发症;当非专业人员非法进行时,它们变得不可避免。未经授权,以及在未经认可的设施中肆无忌惮的从业人员。必须警告患者,遵守法规至关重要,只有在认可的设施中合法执业的训练有素的认证专家才能安全有效地解决他们的问题。
本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
Volume restoration and enhancement of the gluteal region appearance has become nowadays a popular concern in particular for many women. Several options are available, none however are without complications and side effects. Volume enhancement with soft tissue fillers of the gluteal region is emerging as a highly attractive minimally invasive modality. It has led unfortunately to more unlicensed, nonmedical practitioners administering illicitly injections for buttock augmentation at relatively low costs.
To determine safety, efficacy, and cost effectiveness of mostly used soft-tissue fillers for buttock augmentation, a systematic literature search of PubMed, Medline, and Embase was conducted to identify the mostly used fillers for gluteal augmentation. It was complemented by searching for each of the identified filler material separately to retrieve any missed reports. References of clinical studies and trials, reviews, and consensus reports were reviewed as well for the same objective.
In the final analysis 12, mostly strongly biased clinical reports providing a low level of evidence, were identified for inclusion in the review. Two studies involved Polymethylmethacrylate (PMMA), 5 Poly-L-lactic acid, 1 Calcium hydroxyapatite and 4 hyaluronic acid filler injection. No studies were identified involving liquid silicone or Polyacrylamide hydrogel. The little available evidence provided by this review indicates that a specific brand of PMMA in Brazil has a demonstrable relatively good safety, efficiency, and cost-effectiveness record superior to surgical alloplastic gluteal augmentation or to lipofilling only when injected by experts.
Gluteal augmentation with soft tissue fillers is not as simple and innocuous as advertised. Serious complications may occur. Moreover, optimal buttock contouring entails not only volume augmentation but also volume removal; thus, volume augmentation with soft tissue fillers may not be ideal. Popularizing this modality must also be approached with great care. Serious complications do occur; they become inevitable when performed illegally by non-specialized, non-authorized, and unscrupulous practitioners in non-accredited facilities. Patients must be warned that adherence to regulations is critical and that only well-trained certified experts practicing legally in accredited facilities can address safely and efficiently their concerns.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .