Background: Volumizing muscles in the thighs by fat grafting to complement body contouring surgeries has not been adequately investigated. Our objective was to describe a technique (VDVFAT) that defines and volumizes thigh muscles by lipotransfer in the vastus medialis and vastus lateralis muscles. Methods: VDVFAT was performed in 52 patients by the same surgeon at a private clinic in Lima, Peru, between 2018 and 2019. All patients were aged between 18 and 60 years, had no cutaneous flaccidity of the thighs, had a body mass index less than 28, and had Goldman surgical risk below Class II. Results: A total of 45 women aged 19–41 years (mean: 29.2 years) and seven men aged 24–41 years (mean: 33 years) were included. A mean of 173.36 cm3 of intramuscular fat was grafted to the vastus lateralis, resulting in increased muscle thickness of 21.09 mm, which is equivalent to 88.31% of the initial size of the muscle (P < 0.0001). An intramuscular fat mass of 123.53 cm3 was grafted into the vastus medialis, resulting in increased muscle thickness of 30 mm, which is equivalent to 87.02% of the initial size of the muscle (P < 0.0001). Conclusions: Volumizing and defining the vastus muscles by fat transfer is a safe and reproducible method for defining and volumizing muscles. However, further studies are necessary to determine the durability of fat grafts.

Background: The profunda artery perforator (PAP) flap has been reported in several types of reconstructions. This report aims to evaluate the usefulness and the clinical outcome of patients who underwent the PAP free flap for lower limb reconstruction.Methods: Between February 2018 and February 2020, nine patients with injury at lower third of the leg, foot dorsum or foot plant (eight acute injuries and one chronic ulcer) were selected. Mean wound size was 12.5 × 6.3 cm (9 × 5-14.5 × 6.5). Inclusion criteria consisted in patient's request to hide the donor site scar and the absence of previous traumas or surgery in the donor site. Patients considered unable to bear prolonged surgery were excluded. Patients underwent preoperative CT angiography and peri-operative Doopler, for perforator selection. All flaps were designed with pinch test, in elliptical shape. Microvascular anastomosis was performed to the tibialis anterior/posterior or medial plantar vessels. Outcomes were evaluated in terms of wound coverage success and patient's quality of life through Lower Extremity Functional Scale (LEFS) questionnaire. Results:The mean size of the harvested skin paddle was 13.5 × 7.4 cm (9 × 6-15 × 8) and mean pedicle length was 8.5 cm. Mean flap harvest time was 43.5 min . Flap survival rate was 100%, with one re-exploration with minimal partial flap loss. Mean follow-up was 13.5 months . Reconstructive results were successful in wound coverage and function. All patients reported satisfaction with their result by LEFS questionnaire (score:64.7). Conclusion:With proper patient selection, there was 100% flap survival rate with no major complication. According to our data, the PAP free flap could be a valuable option for lower extremity reconstruction. | INTRODUCTIONInjury to the lower limb poses a challenge to reconstructive surgeons because they require early intervention often involving a multidisciplinary approach. Initial management of the affected extremity will be determined by the cause of injury, as it is necessary to stabilize the patient and determine suitable reconstructive options. These injuries include trauma (crushing, car accidents, high altitude falls) and high voltage burns among others (Patterson et al., 2019). Every patient should receive individualized treatment tailored to the injury and it will

Background: In body contouring surgery, some regions, such as the abdomen, thorax, upper limbs, and glutes, are prioritized over others, including the lower limbs, particularly the anterior thighs. This study aimed to identify anterior thigh preferences by age, sex, ethnicity, and region and assess their importance as a factor of female beauty by conducting an online survey. Methods: Photographs of a 24-year-old female model were modified in two front-view and side-view panels. Through a survey on the Amazon Mechanical Turk platform, participants were asked to order the images from the most beautiful to the least beautiful, and the results were broken down by age, sex, ethnicity, and region. Results: A total of 1000 respondents were surveyed, all of whom answered the survey without error; therefore, no one was excluded. Of the 1000 respondents, 504 were men (50.4%) and 496 were women (49.6%). The predominant age group was 26−35 years, with 443 people (44.3%), the region with the highest number of participants was North America, with 484 respondents (48.4%), and the predominant ethnicity was White, with 555 respondents (55.5%). The survey showed that the most beautiful images were image A on the side-view panel (25.9%) and image I on the front-view panel (28.5%)( P < 0.001). Conclusions: In the side view, the aesthetic preferences of the anterior thigh do not appear to be associated with the anterior projection. However, in the front view, the increase in width generates a beauty trend, but only up to an intermediate level, quantified in the ratio (0.44).