Gluteal augmentation is one of the most requested cosmetic procedures. This article describes the surgical technique and early results of an innovative minimally invasive video-assisted submuscular gluteal augmentation with implants. The authors aimed to perform a technique that would reduce complications and surgical time. Fourteen healthy non-obese women with no relevant pathologic background who requested gluteal augmentation with implants as a single procedure were included. The procedure was performed through bilateral parasacral 5 cm incisions at cutaneous and subcutaneous planes as far as the gluteus maximus muscle fascia. Through a 1 cm incision in the fascia and muscle, the index finger was introduced under the gluteus maximus and a submuscular space was created by blunt dissection towards the greater trochanter to avoid a sciatic nerve injury, until the middle gluteus level was reached. Next, the balloon shaft of a Herloon trocar (Aesculap® - B. Brawn®) was introduced in the dissected space. Balloon dilatation in this submuscular space was performed as required. The balloon shaft was replaced by the trocar, through which a 30° 10-mm laparoscope was introduced. Submuscular pocket anatomic structures were observed, and while the laparoscope was being retrieved, hemostasis was verified. The submuscular plane collapsed, leaving the pocket for the implant to be placed. There were no intraoperative complications. The only complication was a self-limited seroma in one patient (7.1 percent). This innovative technique has shown ease and safety, allowing direct visualization and hemostasis, with a short surgical time, low complication rate and an excellent degree of satisfaction.
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