BACKGROUND: Aesthetic goals in abdominoplasty are changing as patients desire not only a thin waist but also an hourglass figure with round hips. Standard body contouring techniques do not necessarily address the hip as an aesthetic unit, and rarely work to expand the hip. The authors present their experienced using fat transfer for hip expansion, which can be useful in various aesthetic procedures, including abdominoplasty. This technique allows for the hip to be contoured into an aesthetically pleasing hourglass figure. The authors also describe the hip aesthetic unit and its boundaries and specific contours, which should be addressed to achieve a youthful body profile when fat grafting for hip expansion.
METHODS: A retrospective review was performed by the senior author (W. C.). Medical records of patients who underwent hip expansion with abdominoplasty between March 1st, 2014 and May 31st, 2022 were analyzed. Every patient had a minimum follow-up time of one year. A total of 1125 consecutive cases were found. Photographic records were taken before and during follow-ups at 1 month, 3 months and 12 months.
RESULTS: Hip expansion with fat grafting with abdominoplasty was successfully achieved in 1125 cases. Average age was 38 years old (standard deviation: 8 years, maximum: 68 years, minimum: 20 years). Average body mass index (BMI) was 29 kg/m2 (standard deviation: 4 kg/m2, maximum: 42 kg/m2, minimum: 18 kg/m2). Average amount of aspirated fat was 1896 ccs (standard deviation: 760 ccs, maximum: 3000 ccs, minimum 400 ccs). Average amount of fat injected into the bilateral hips was 493 ccs (standard deviation: 220 ccs, maximum: 1700 ccs, minimum: 50 ccs). Complications were as follows: Bleeding requiring transfusion (N = 6, 0.5%), infection (N = 19, 1.7%), seroma (N = 6, 0.5%), fat necrosis (N = 10, 0.9%), incisional dehiscence (N = 25, 2.2%), spitting sutures (N = 4, 0.4%), hematoma (N = 3, 0.3%), pulmonary embolism (N = 3, 0.3%), deep vein thrombosis (N = 4, 0.4%) with one case resulting in mortality, and medical complications including hypertension, urinary retention, and urinary tract infection (N = 26, 2.3%).
CONCLUSION. Adding a hip expansion to popular cosmetic procedures such as abdominoplasty offers a safe and reliable technique that improves patient surgical results. This technique should be part of a plastic surgeon armamentarium, particularly for patients who request an improved waist-to-hip ratio. The authors recommend adding the hip anatomical area as a new aesthetic unit that needs to be taken into consideration.