Plastic and Reconstructive Surgery

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PRSonally Speaking
Monday, February 24, 2014
Articles of Interest: The Graft to Capacity Ratio - Volumetric Planning in Large Volume Fat Transplantation
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
When the article is published in print with the March issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
This week we present the introduction to "The Graft to Capacity Ratio - Volumetric Planning in Large Volume Fat Transplantation" by Del Vecchio et al.
Background: Variability in large volume fat transplantation has been linked to technique. Meanwhile, the recipient site volume and its relation to the volume of grafted fat has been relatively overlooked. Graft to capacity concepts are evidenced in
other soft tissue transplantation procedures such as skin and hair transplantation. We define the Graft to Capacity Ratio as the volume of grafted fat in relation to the volume of the recipient site. We postulate its theoretical limits, and empirically analyze its
potential clinical importance in large volume fat transplantation.
Methods: Thirty cases of large volume fat transplantation to the breast were reviewed. All patients underwent pre-operative quantitative volumetric analysis using threedimensional breast imaging and underwent large volume fat transplantation using the large syringe technique. The volume of fat transplanted into each breast at the time of surgery was noted. Quantitative volumetric breast imaging was repeated 12 months postoperatively.
Results: The average Graph to Capacity Ratio was 117% with a standard deviation of 22%, consistent with deduced theoretical limits. Cases where the Graft to Capacity Ratio exceeded one standard deviation demonstrated lower percent volume maintenance. Cases where the Graft to Capacity Ratio was lower than one standard deviation appeared to demonstrate higher percent volume maintenance. Univariate linear regression of percent volume maintenance as a function of Graft to Capacity
demonstrated a significant inverse relationship.

Conclusion: The Graft to Capacity Ratio appears to be a relevant variable in percent volume maintenance outcomes and may be useful in establishing consistency in large volume fat transplantation.
The full article will be published with the March 2014 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.
About the Blog

Plastic and Reconstructive Surgery

PRSonally Speaking is the official blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit our blog for exclusive previews of and discussions on hot topics in plastic surgery as well as insider-tips on open access content. PRSonally Speaking is now powered by frequent contributions from the American Society of Plastic Surgeons’ Young Plastic Surgeons Forum (YPS); these practicing plastic surgeons provide the personal side of the plastic surgery story, from daily challenges to unique insights. PRSonally Speaking is home to lively, civil debate on hot topics and great discussions pertaining to our field. So, bookmark us, subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your Journal; have fun, be respectful, get engaged and interact with the PRS community.

The views and recommendations of guest contributors do not necessarily indicate official endorsements or opinions of the Journal, PRS, or the ASPS. All views are those of the authors and the authors alone.


Anureet K. Bajaj, MD is a practicing plastic surgeon in Oklahoma City. She completed residency and fellowship in 2004, had a brief stint in academia at the University of Cincinnati, and then chose to join her father (Paramjit Bajaj MD, also a practicing plastic surgeon) in private practice in OKC, where she focuses on breast reconstruction and general cosmetic surgeries.

Devra B. Becker, MD, FACS, is an Assistant Professor of Plastic Surgery in the Department of Plastic Surgery at University Hospitals/Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed Plastic Surgery residency at Washington University School of Medicine in St. Louis, and completed fellowships with Daniel Marchac and with Bahman Guyuron. She currently has a primarily reconstructive practice.

Henry C. Hsia, MD, FACS is at Robert Wood Johnson Medical School of Rutgers University in New Brunswick, New Jersey and also holds an appointment at Princeton University.  When he’s not working hard trying to be a good father and husband, he runs a practice focused on reconstructive surgery and wound care as well as a research lab focused on wound biology and regenerative medicine.

Stephanie K. Rowen, MD is a senior physician at The Permanente Medical Group in San Jose, California.  She joined TPMG upon finishing residency and a hand surgery fellowship in 2005.  She has a primarily reconstructive practice, about 50% hand surgery.  Outside of work she enjoys participating in triathlons and spending time with her family.

Jon Ver Halen, MD is currently Chief of plastic surgery, Baptist Cancer Center; Research member, Vanderbilt- Ingram Cancer Center; Adjunct clinical faculty, St. Jude Children's Research Hospital. He also acts as Program Director for the plastic surgery microvascular surgery fellowship. His practice focuses on oncologic reconstruction.

Tech Talk Bloggers

Adrian Murphy is a plastic surgery trainee in London, England. He studied medicine in Dublin, Ireland and has trained in Ireland, Boston, MA and the United Kingdom. He is a self-confessed geek and gadget aficionado.

Ash Patel, MD is Assistant Professor of Plastic Surgery and Associate Program Director at Albany Medical College, in Albany NY. His practice is primarily reconstructive.