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Real-Time Ultrasound–Assisted Gluteal Fat Grafting

Cansancao, Alvaro Luiz, M.D.; Condé-Green, Alexandra, M.D.; Vidigal, Rafael A., M.D.; Rodriguez, Ricardo Luis, M.D.; D’Amico, Richard A., M.D.

Plastic and Reconstructive Surgery: August 2018 - Volume 142 - Issue 2 - p 372–376
doi: 10.1097/PRS.0000000000004602
Cosmetic: Ideas and Innovations
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Background: The number of gluteal fat augmentation procedures has increased recently and so has the number of complications. Because of the increased risk of morbidity and mortality when fat is injected intramuscularly, not knowing where fat is injected is concerning. We sought to identify the planes in which fat is injected during the procedure.

Methods: We selected 15 consecutive female patients who desired gluteal fat augmentation. All patients had epidural anesthesia and the gluteal region was infiltrated with a vasoconstrictive solution. With the patient in prone position, an ultrasound probe placed on the buttocks was used to identify the fascial layers. While decanted fat was being injected with a blunt cannula, the images were projected wirelessly to a screen, so that the surgeon and assistant could follow the planes in which the cannula was being introduced and the fat injected.

Results: The mean volume of harvested fat was 3533 ml and the mean volume of fat injected per gluteal region was 528 ml. The evaluation of the depth and location of the cannula was performed in real time with the ultrasound, accurately and reliably identifying the planes of fat injection. All injections were subcutaneous. The downsides of this technique were the purchase cost of the ultrasound device, increased surgical time, the need for an assistant to follow the cannula and the probe constantly, and the learning curve.

Conclusion: Real–time ultrasound–assisted gluteal fat grafting is reliable and may avoid injuring the deep vessels, further decreasing the risks of major complications.

Rio de Janeiro, Brazil; Newark and Englewood, N.J.; and Baltimore, Md.

From the Department of Plastic Surgery, Universidade Iguaçu, Hospital da Plástica; the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; the Department of Plastic Surgery, Englewood Hospital and Medical Center; Cosmetic Surgery; and the Department of Plastic Surgery, The Johns Hopkins University.

Received for publication October 24, 2017; accepted January 31, 2018.

Presented at Plastic Surgery The Meeting 2017, Annual Meeting of the American Society of Plastic Surgeons, in Orlando, Florida, October 6 through 10, 2017.

Disclosure: The authors declare no conflicts of interests with respect to the authorship and/or publication of this article.

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Alvaro Luiz Cansancao, M.D., Avenida das Americas 3200, sala 212, Rio de Janeiro, Brazil 22640-102, dr.alvaroluiz@hotmail.com

©2018American Society of Plastic Surgeons