Three-flap Technique: Comprehensive Approach for Biopolymer Removal in the Gluteal and Lumbar Regions

Biopolymer disease, caused by illicit injection of synthetic fillers, presents significant health risks and emotional distress. The gluteal and lumbar regions are common sites for such procedures. This study introduces the 3-flap technique-a novel surgical approach designed for effective biopolymer removal with improved aesthetic and symptomatic outcomes.

A retrospective cohort study was conducted on 199 female patients treated with the 3-flap technique between January 2022 and September 2024 in Medellín, Colombia. Preoperative evaluation included clinical classification, magnetic resonance imaging, and symptoms. Surgical outcomes, complications, and postoperative symptom resolution were assessed through clinical records and patient-reported data. Statistical analysis was performed using univariate and multivariate techniques in Jamovi software.

The average patient age was 43.1 years with a body mass index of 24.2 kg/m². Common comorbidities included hypothyroidism and anemia. The average surgical duration was 270 minutes, with a hemoglobin drop of 3.3 g/dL postoperatively. Complications included drain placement (29.1%), dehiscence (21.1%), and tissue necrosis (3.5%). Postsurgical improvement was observed in gluteal ptosis, quality-of-life markers, and symptoms. Statistically significant reductions were seen in symptoms such as myalgia (odds ratios [OR], 0.15), asthenia (OR, 0.03), and anxiety (OR, 0.08). Well-being indicators such as sleep quality and exercise frequency also improved.

The 3-flap technique is a safe and effective method for removing biopolymers from the gluteal and lumbar regions, yielding high patient satisfaction and substantial symptom relief. Further studies are needed to quantify biopolymer removal and compare outcomes with alternative techniques.