Avaliação volumétrica e funcional do músculo glúteo máximo submetido a gluteoplastia de aumento com implantes de silicone

Abstract

The gluteal augmentation surgery using implants began in the late 1960s, however intramuscular technique, which is considered standard today, was described about 30 years later. Plastic surgeons and patients have increased interest in gluteal augmentation given the fact that the operation has been more frequently in recent years. The use of intramuscular implants that overcomes the muscle volume in more than fifty percent configures a new situation that should be studied. The skeletal muscle tissue shows high susceptibility to atrophy secondary to compression, and the gluteus maximus is an important muscle in the maintenance of erect posture, walking, running and jumping, it is necessary to investigate possible muscle changes resulting from the operation. The objective of this study is to assess the volume and strength of the gluteus maximus muscle during 12 months after the introduction of the implants, the position of these implants within the muscles and anthropometric changes obtained with the operation. 48 women were selected, 24 candidates for gluteal augmentation composed the study group and 24 candidates for breast augmentation composed the control group according to the criteria of inclusion and exclusion. The patients were evaluated at four different moments: pre-operatively and after three, six and 12 months of the operation. At all stages of the study, was carried out nutritional evaluation, CT with 3D reconstruction and isokinetic testing. All patients remained away from physical activities for three months after the operation. Cohesive gel, oval base and smooth surface gluteal implants were used with volumes of 350 cm3 and 400 cm3. The level of statistical significance was 5%. The patients who were candidates for gluteoplasty presented bigger waist to hip ratio than those of the control group. The operation of gluteal augmentation using implants has shown to be effective in improving this ratio. The implants showed similar oblique position of the muscle fibers after three months of operation, regardless of the position in which they were placed. The patients in the study group had muscle atrophy after 12 months, 6.14% 6.43% left and right, the control patients showed no atrophy. Muscle strength decreased the maximum torque during hip flexion at 30 °/s in both groups and increased maximum torque during the adduction at 60 °/s only in the study group. We conclude that the introduction of silicone implant within the gluteus maximus muscle causes muscle atrophy after 12 months. Variations in the strength of this muscle during this period cannot be attributed primarily to the operation or the presence of implants. The implants remained in oblique position. The gluteal augmentation surgery generates anthropometric changes in women who have undergone this operation.