Is fat injection into muscle recommended?

Thank you for your question.  Fat injection into the muscle used to be very common but there is evidence of increased risk of fat embolism so I don't inject into the muscle anymore.  I have been in practice for 18 years and do not see a big difference in fat survival, so in my opinion, it's not worth the risk to inject into the muscle.

Thank you for your question. In my practice, I do not inject into the muscle due to the seriousness of the fat embolism. Your glutes contain many major blood vessels that increase the possibility of this happening. I do not see any benefit in my practice that would outweigh the risk of the fat embolism to inject into the muscle. It would be up to you to request that and ensure that all of your consent forms state that as well if this is the road you choose to take. 

I wish you the best of luck!

I inject above the muscle into the fat to help avoid this and the fat graft take is very good in my experience.

Fat embolus is a very serious and known complication of fat transfer. While it is true, injection of donor fat into the infra-muscular plane (within the muscle) increases fat viability this does come with a significant increase in risk. There are large vessels deep to and within the muscle which can be inadvertently injected while grafting leading to a fat embolus. The consequences of such a complication are very serious and life threatening.At the recent American Society of Plastic Surgeons Hot Topics, data from AAAASF (ambulatory surgical certifying body) was presented, suggesting that BBL /gluteal lipoaugmentation demonstrates a dramatically higher risk profile than other surgeries. The Aesthetic Surgery and Educational and Research Fund is convening a task force as well. The hope is that we will have more concrete guidelines for addressing these very serious complications.That being said, the safest way to avoid fat emboli is to stay in the subcutaneous plane (at the expense of fat viability)and avoid the deeper muscular plane. If grafting of the deep plane is planned, surgeons should consider blunt cannulas, aspiration prior to injection. Using a supra-gluteal approach to minimize the risk of inadvertent intravascular injection has also been proposed.As always, discuss your concerns with a board certified plastic surgeon.

I personally stay above the muscle to lessen chances of a fat embolism.  Many plastic surgeons do indeed inject into the muscle.  Yes, a percentage of fat injected into the fat layer will survive the transfer.