A Retrospective Study of Nonsurgical Management Options for Permanent Filler Complications of the Gluteal Region.

Background: Gluteal or hip augmentation with nonresorable (permanent) fillers can lead to complications. Nonsurgical treatment options are unclear and are mainly based on case reports. This study aimed to examine which treatment option is the better choice for patients with complications after permanent fillers in the buttocks. Methods: In this retrospective cohort study, the data of patients visiting our hospital clinic with complications between 2016 and 2021 after gluteal or hip augmentation with fillers were analyzed. Contingency table analyses were conducted to determine which of the 5 types of treatments, minocycline, surgery, intralesional laser treatment (ILT), pressure garments, and omega-3 supplements, were related to pain relief and softening of the nodules. Results: Seventy-two patients (69 women and 3 men; mean age, 39 y) were selected. Inclusion criteria were men and women older than 18 years of age with complications after gluteal or thigh augmentation with permanent fillers. Filler material was mainly found in the buttocks and hips. Treatment options were antibiotics, surgery, laser, pressure garment, and omega-3 supplements. Pain relief was reported in 36 of the 42 responders. Softening of the nodules appeared to be positively associated with ILT (odds ratio = 20.25). Conclusions: The most common complication was subcutaneous inflammation (panniculitis) in the buttocks and hips. Most patients reported reduced pain and softening of the nodules after treatment. The latter outcome appears to be related to the ILT. Considering the information in the literature and our findings, a step-by-step treatment protocol was developed.