Ultrasound-Guided Gluteal Fat Grafting: What is the Evidence? A Systematic Review and Meta-Analysis.

Summary

Across 6,235 patients, ultrasound-guided gluteal fat grafting demonstrated no reported mortality or fat embolism and low rates of minor complications. These findings support ultrasound guidance as a safer technique that aligns with recommendations to avoid intramuscular injection.

Key Findings

• No reported mortality or fat embolism across 6,235 patients undergoing ultrasound-guided gluteal fat grafting
• Low pooled minor complication rate (6.32 per 100), including seroma (2.94/100), infection (0.23/100), and fat necrosis (0.09/100)
• Use of Freeman–Tukey transformation and R-based meta-analysis with low heterogeneity (I² = 0 for fat necrosis)

Clinical Implications

Clinicians should adopt ultrasound guidance for gluteal fat grafting, emphasize subcutaneous-only injections, and integrate training/credentialing to reduce catastrophic complications.

Limitations

• Only four studies included and all patients were female, limiting generalizability
• Observational evidence with potential underreporting and lack of long-term follow-up

Future Directions

Prospective registries and standardized ultrasound protocols with competency benchmarks; assessment of long-term outcomes and cost-effectiveness.