https://orcid.org/0000-0003-3436-3304
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Filiberto Alejandro Alvarez-Alvarez, Hiram O González-Gutiérrez, César Felipe Ploneda-Valencia, Safe Gluteal Fat Graft Avoiding a Vascular or Nervous Injury: An Anatomical Study in Cadavers, Aesthetic Surgery Journal, Volume 39, Issue 2, February 2019, Pages 174–184, https://doi.org/10.1093/asj/sjy237
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Abstract
Fat grafting for gluteal augmentation is one of the most popular aesthetic surgery procedures. It has an associated mortality to fat embolism of 0.2%.
The authors of this study sought to describe which technique for synthetic graft application was least likely to cause a fat embolism.
Ten fresh bodies were obtained and 4 groups arranged with 5 buttocks each randomly assigned. Group 1 was infiltrated through the upper medial intergluteal sulcus (upper medial intergluteal sulcus) with an angulation of −30°, −10°, and 0°. Group 2 was infiltrated through the middle lower gluteal sulcus with an angulation of −30°, 0°, and +15°. Group 3 was infiltrated through a peritrochanteric (PT) access at the level of the femur head at 0° and +10° and in the middle of the buttock at the level of the posterior superior iliac crest at −30° toward the trochanter (lateral direction). Group 4 was infiltrated in the same manner as group 1 without −30°. A complication occurred when the graft was in contact with the vascular or nervous bundle, within the gluteus medius muscle, or both.
Group 1 had 3 buttocks with a complication (UMIGS −30°). Group 2 had complications in all the injection techniques. Group 3 had 5 buttocks with a complication (PT at 0°). Group 4 had no complications.
The injection of the fat graft through the UMIGS at 0° and 10° angles, and through the middle of the buttock at the level of posterior superior iliac crest a −30° angle, reaches the surface needed for gluteal augmentation. The group 2 techniques should be avoided because they have a high risk of complication.
