What is the World Association of Gluteal Surgeons?

World Association of Gluteal Surgeons

WAGS stands for the World Association of gluteal surgeons, an organization of physicians from around the world who are dedicated to advancing the science of buttock surgery. Surgeons have formal training from a wide range of surgical specialties. The World Association of Gluteal Surgeon’s mission is to promote the safety of buttock surgery. Specifically, the most recent increase in detrimental complications relating to the incidence of fat emboli have shifted the organization’s focus to reassessing and determining protocols to improve Brazilian buttock lift (BBL) safety.

In 2021, the organization completed a survey of 95,000 BBL cases from throughout the world. They found that  54% of cases were performed by plastic surgeons and 48% by cosmetic surgeons. The number one complication following BBLs was seroma formation at 4.4% and an incidence of death from fat emboli at 1 in every 26,000 BBLs. This incidence of BBL fat emboli deaths is promising as it is far lower than the previously identified incidence of 1 in 3000 published in 2017.

What is the WAGS focused on?

The most recent focus of the World Association of Gluteal Surgeons has been to understand the most recent uptick of deaths. More specifically, there have been 7 deaths just in Miami in only 6 months in 2022. The World Association of Gluteal Surgeons members joined forces at the end of May to reconsider the causes of locally increased numbers of detrimental complications occurring in Miami. Factors considered were the surgeon’s inexperience with lack of buttock anatomy and procedural techniques, surgeon fatigue, and the possibility that fat grafting was actually not performed by the surgeon and instead by surgical assists. In addition, discussions were made regarding developing surgical tools using advances in science that could assist surgeons to avoid the deposition of fat in or under the muscle.

How do you avoid BBL complications?

Avoidance of fat injection into or under the muscle is the mainstay of Brazilian buttock lift surgery since this single factor has been found to be the underlying common thread involved in BBL-related fat emboli deaths. Several advancements were discussed at the 2022 World Association of Gluteal Surgeons meeting to improve control of fat grafting cannulas:

1. Fat grafting cannula with a light source at the tip that can be visualized to help surgeons ensure that they are not below the muscle
2. Fat grafting cannula with the capacity to measure differences in impedance between fat and muscle tissues, thus providing a feedback mechanism to localizing the wand position
3. Ultrasound assistance and development of radiolucent fat grafting cannulas that can be visualized with portable ultrasound monitoring

The urgency of establishing safety in BBL surgery is of the highest priority for World Association of Gluteal Surgeon members at this time. This is because the Florida Medical Board is considering banning all BBL procedures if improved safety profiles are not immediately established. A task force was created to address this very important concern of the World Association of Gluteal Surgeons organization which is dedicated to the promotion of safe BBL surgeries.