Prevention of Fat Embolism in Fat Injection for Gluteal Augmentation, Anatomic Study in Fresh Cadavers

Ramos-Gallardo, Guillermo; Orozco-Rentería, David; Medina-Zamora, Pablo; Mota-Fonseca, Eduardo; García-Benavides, Leonel; Cuenca-Pardo, Jesús; Contreras-Bulnes, Livia; Ambriz-Plasencia, Ana Rosa; Curiel-Beltrán, Jesús Aarón

doi:10.1080/08941939.2017.1321703

Cited by 34 publications

(10 citation statements)

References 27 publications

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“…20 However, this study and many others that influence current techniques were based on animal studies, limiting the applications to humans. 13…”

Section: Resultsmentioning

confidence: 99%

“…4). 7,13,14 Additionally, this area contains the most dense fascial and ligamentous attachments, which require aggressive manipulation and can cause an increased risk of cannula misdirection into the deeper planes and toward major structures. 15 Several incisions have been described for the use of fat grafting for body contouring and buttock augmentation.…”

Section: Operative Techniquesmentioning

confidence: 99%

“…9,12 In fact, Ramos-Gallardo performed a cadaver study showing that fat injection at a 30-degree angle is safer regarding the deeper planes and vital structures versus a 45-degree angle. 13 Additionally, one systematic review showed that of the 19 studies reviewed, 46% reported injecting both intramuscularly and subcutaneously, 27% reported injecting intramuscularly only, and 27% reported injecting subcutaneously and/or subfascially only. 18 More recently, many surgeons have been avoiding injecting fat intramuscularly due to the increased risk of fat emboli.…”

Section: Operative Techniquesmentioning

confidence: 99%

“…1,4,9,11,18 Moreover, many surgeons only perform retrograde injections to ensure the safety of the blood vessels. 1,4,13 Overcorrection, or the injection of extra fat to account for inevitable fat resorption, remains an area of debate with no clear consensus. While some surgeons advocate for overcorrection by as much as 50 to 100%, other surgeons avoid it out of concern for decreased graft viability as the pressure within the buttocks increases.…”

Section: Operative Techniquesmentioning

confidence: 99%

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The Role of Fat Grafting in Buttock Augmentation

O’Neill

Abu‐Ghname

Davis

et al. 2020

Seminars in Plastic Surgery

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Autologous fat grafting is now considered the gold standard for buttock augmentation. Although a variety of techniques are currently being used by surgeons around the world, methods of fat grafting to the buttocks remain unsystematized, poorly understood, and controversial in terms of their safety and efficacy. Nonetheless, buttock augmentation by fat grafting has a satisfaction rate of 97.1%, and its mean complication rate has been estimated to be around 7 to 10%, with serious complications occurring in less than 1% of cases. Fat emboli are one such serious complication, with several reports in the literature discussing morbidity and mortality, specifically with intramuscular injection. With the increasing popularity of fat grafting for buttock augmentation, it is more important than ever to continue researching and learning to safeguard the satisfaction and safety of our patients.

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“…20 However, this study and many others that influence current techniques were based on animal studies, limiting the applications to humans. 13…”

Section: Resultsmentioning

confidence: 99%

Section: Operative Techniquesmentioning

confidence: 99%

Section: Operative Techniquesmentioning

confidence: 99%

Section: Operative Techniquesmentioning

confidence: 99%

See 2 more Smart Citations

The Role of Fat Grafting in Buttock Augmentation

O’Neill

Abu‐Ghname

Davis

et al. 2020

Seminars in Plastic Surgery

View full text Add to dashboard Cite

show abstract

“…The reporting and thorough medico‐legal investigation of gluteal contouring deaths will lead to a better understanding of risk and mechanisms of injury, hopefully, then improving the procedural techniques to eliminate the adverse events. Research is currently being carried out on cadavers to improve the safety and develop best practice parameters regarding the angle of injection and other technical factors in autologous gluteal fat transfer .…”

Section: Discussionmentioning

confidence: 99%

Fatal Complications of Aesthetic Techniques: The Gluteal Region

Rapkiewicz

Kenerson

Hutchins

et al. 2018

Journal of Forensic Sciences

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Cosmetic procedures are common and utilize many techniques to obtain aesthetically good outcomes for patient satisfaction with acceptable safety standards. Cosmetic procedures that involve the gluteal region are becoming increasingly popular as various procedures can target the gluteal region such as liposuction, tumescent liposuction, cosmetic filler injections, autologous fat transfer, depot drug delivery, and implants. Complications of cosmetic gluteal procedures can be localized or systemic with systemic complications being responsible for most deaths. These reported systemic complications include sepsis, thromboembolism, fat embolism with or without fat embolism syndrome, macroscopic fat embolism, anesthesia-related and blood volume abnormalities. We herein report 10 deaths due to elective gluteal cosmetic procedures. Autologous fat transfer (fat grafting, lipoinjection) following liposuction resulted in 8 of 10 fatal outcomes of the gluteal aesthetic procedures. A comprehensive discussion of gluteal anatomy, gluteal contouring procedures, and the approach to such cases is presented along with the autopsy findings of the reported cases.

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Autologous fat transfer—principles, techniques, and outcomes for facial rejuvenation, scars, breast, and buttocks

Roh

Chung

Goyal

et al. 2021

Dermatological Reviews

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Autologous fat transfer is a common method to correct soft-tissue defects. It has been used in various conditions with subcutaneous atrophy induced by trauma or inflammation. Recently, the use has become popular for cosmetic purposes such as facial rejuvenation andbody contouring. In this article, we review the science and method behind its practice and describe other possible indications for autologous fat transfer.

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Prevention of Fat Embolism in Fat Injection for Gluteal Augmentation, Anatomic Study in Fresh Cadavers

Abstract: The location where the vessels come in contact with the muscle, which can be considered for fat injection, were located in quadrants 1 and 3. A 30° angle allows for an injection into the muscle without passing into deeper structures, unlike a 45° injection angle.

Cited by 34 publications

References 27 publications

The Role of Fat Grafting in Buttock Augmentation

The Role of Fat Grafting in Buttock Augmentation

Fatal Complications of Aesthetic Techniques: The Gluteal Region

Autologous fat transfer—principles, techniques, and outcomes for facial rejuvenation, scars, breast, and buttocks

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