Severe postoperative infection after intramuscular silicone buttock augmentation via intergluteal fold incision: Case...

Intramuscular buttock augmentation with silicone implants can produce immediate and durable contour enhancement but carries notable complication risks, particularly postoperative infection. The intergluteal fold approach, although offering optimal scar concealment, presents anatomical vulnerabilities that may predispose to contamination and impaired wound healing.

A 21-year-old woman developed a severe postoperative infection following bilateral intramuscular buttock augmentation via a 7 cm intergluteal fold incision. On postoperative day 5, she presented with severe gluteal pain, swelling, erythema, and systemic symptoms. Computed tomography demonstrated bilateral periprosthetic fluid collections and subcutaneous emphysema. Microbiological culture identified coagulase-negative Staphylococcus sensitive to beta-lactams.

The patient underwent urgent intravenous antibiotics, targeted antimicrobial adjustment, and staged surgical wound management involving deliberate incision reopening, thorough irrigation, and passive drainage, without implant removal. Complete infection resolution was achieved by postoperative day 21, though notable intergluteal scarring developed.

This case illustrates the infection risk associated with the intergluteal fold approach in intramuscular gluteal augmentation. Early recognition, aggressive multidisciplinary management, and carefully selected implant-preserving strategies may achieve resolution without explantation. Surgeons must weigh aesthetic advantages against anatomical infection risks and ensure comprehensive patient counseling.