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Results Of The Gluteal Fat Grafting Multi-society Task Force Anatomic Study
David Turer, MD; Pat Pazmino, MD; Oni Garcia, MD; Joe Finocchiaro, EJD, CFSP; Emma Lew, MD; James Fernau, MD; Dan Mills, MD; Renato Saltz, MD; Richard D'Amico, MD; J. Peter Rubin, MD
University of Pittsburgh Medical Center
2019-02-15
Presenter: David Turer
Affidavit:
Dr. Turer was a contributor to this study. He participated in the anatomic study and assisted in dissection of the cadavers after injection.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: A significant safety issue in plastic surgery is the risk of morbidity and mortality associated with gluteal fat grafting. The importance of this issue is highlighted by the formation of a multi-society task force to further elucidate the safety issue and develop strategies for mitigating risk. A series of anatomic studies were conducted using fresh cadavers to determine safe approaches to gluteal fat grafting. Methods: The iliac veins of fresh cadavers were prepped with catheters to allow retrograde infection of radiopaque contrast. Multiplanar fluoroscopy was used to map the distance and angles required to cause vascular injury from multiple injection sites. Expert injectors then performed gluteal fat grafting procedures using their preferred technique and dyed human fat. The cadavers were dissected to assess for the presence of sub-muscular fat or vascular injury. Results: We successfully performed angle mapping of four approaches to the gluteal vessels and will present these results. Six expert injectors performed the gluteal fat grafting procedure using their preferred technique. Five injectors intended to stay subcutaneous and on dissection, no intramuscular or submuscular fat was appreciated. One injector intended to inject the lateral gluteal maximus muscle, and on dissection was able to keep injected fat in the lateral buttock. No vascular injuries were appreciated during dissection. Conclusion: This study demonstrates approaches that will produce vascular injury during gluteal fat grafting. Expert injectors are able to perform the procedure safely without violating the intramuscular or submuscular space.