Buttock Surgery: Key Insights, Challenges, and Best Practices-A Scoping Review.

INTRODUCTION Gluteal contouring encompasses diverse surgical and minimally invasive approaches, but technique selection and safety depend on anatomy, patient characteristics, and the quality of a heterogeneous evidence base.

Methods

This scoping review was conducted from January 2024 through June 2025 and reported in accordance with PRISMA-ScR. PubMed and Embase were searched from inception through June 2025. Two reviewers independently screened records and charted data using a predefined form; disagreements were resolved by a senior author. Eligible sources addressed gluteal anatomy, indications, operative or injectable techniques, perioperative care, complications, or safety.

Results

The searches identified 938 records, and 44 sources were included. Evidence ranged from anatomical studies and technical reviews to case series, systematic reviews, and safety guidance. The mapped evidence supports individualized planning, subcutaneous-only fat grafting with ultrasound visualization, and cautious implant plane selection. Fat grafting had lower aggregate complication rates than implants in comparative reviews but retained the risk of fatal embolism when performed in unsafe planes. Evidence for fillers and several lifting or flap techniques was limited and heterogeneous.

Conclusions

Safe gluteal contouring requires anatomy-based planning, procedure-specific patient selection, and adherence to contemporary safety measures. Ultrasound guidance strengthens control of the fat injection plane, whereas the relative superiority of submuscular versus intramuscular implants remains uncertain. Higher-quality comparative studies with standardized outcomes are needed. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .