**7. Safety considerations**

## **7.1 Infection prevention**

Even though gluteal augmentation surgery has an incidence of infection of <1%, surgeons should avoid this serious complication at all cost. Patients should clean their entire body with an antiseptic skin cleanser the night before or the morning prior to surgery (i.e., Hibiclens® soap). All of our patient's get a double prep prior to surgery. One sterile prep takes place prior to tumescent or local anesthesia infiltration and the other prep takes places prior to incision time. Antibiotic prophylaxis with 2 g Ancef q4h, Unasyn 3 g q6h, and gentamicin 5 mg/kg/24 h [6]. In addition, the peri-anal area is also covered with a lap sponge soaked in betadine solution plus a seal over it using a 3 M™ Ioban™ adhesive intra-operatively, using a closed liposuction system for high volume fat harvesting and reinjection prevents the fat from ever being exposed to the open air in the operating room. Thus, reducing the risk for airborne pathogens. Prior to re-injection of fat, the harvested fat in the 3 L canister is treated with an antibiotic solution containing 250 cc of normal saline, 600 mg of clindamycin, and 80 mg of gentamicin. Lastly, all liposuction and injection punctures sites are sutured and sealed with sterile tegaderm dressings.
