Boston, Mass.; and Shreveport, La.
From the Department of Plastic Surgery, Massachusetts General Hospital; the Department of Plastic Surgery, University of Texas Southwestern; and the Department of Surgery, Louisiana State University Health Sciences Center at Shreveport.
Plast Reconstr Surg. 2018 May;141(5):639e-649e. doi: 10.1097/PRS.0000000000004338.
Despite rapid growth, gluteal fat transplantation is an operation in search of science and a teachable technique. Long operating times, tedious syringe transfers, inability to shape the recipient site, and the risk of fat embolism all headline as impediments to clinical adoption of the procedure. Expansion vibration lipofilling is a syringe-free surgical strategy that is a logical extension of Separation, Aspiration, and Fat Equalization (SAFELipo). In expansion vibration lipofilling, there is simultaneous disruption of recipient-site connective tissue, internal expansion using exploded-tip cannulas, and backfilling of these spaces with roller pump-propelled fat.
Two thousand four hundred nineteen consecutive cases of expansion vibration lipofilling fat transplantation to the buttocks were reviewed. Average follow-up was 12 months. The technique of expansion vibration lipofilling is dependent on the use of larger caliber cannulas attached to a roller pump and to an oscillatory power-assisted liposuction device, which is less labor-intensive, potentially allowing for better knowledge of cannula-tip location at all times during the procedure.
Operating times averaged 1 hour 40 minutes. The average volume of fat inserted was 1003 cc. Complications included donor-site seroma, infection, and one pulmonary embolism treated with anticoagulation. There were no cases of fat embolism or death.
Expansion vibration lipofilling is a new method for large-volume fat transplantation. Avoidance of fatal fat emboli demands a surgeon's complete knowledge of cannula tip location at all times during the procedure. Syringe-free, larger caliber, and less flexible cannulas, combined with techniques requiring less operator upper extremity effort resulting in less fatigue, may contribute to avoidance of this dreadful complication.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
尽管臀脂垫移植术发展迅速，但它仍是一项有待完善的技术。手术时间长、注射器转移繁琐、无法塑造受区、脂肪栓塞风险等因素，都阻碍了该手术的临床应用。膨胀振动脂肪填充术是一种无注射器的手术策略，是分离、抽吸和脂肪均衡（SAFELipo）的逻辑延伸。在膨胀振动脂肪填充术中，同时破坏受区结缔组织，使用爆炸尖端套管进行内部扩张，并使用滚轴泵推动脂肪填充这些空间。
回顾了 2419 例连续的膨胀振动脂肪填充臀部脂肪移植病例。平均随访时间为 12 个月。膨胀振动脂肪填充技术依赖于使用较大口径的套管连接到滚轴泵和振荡动力辅助吸脂装置，该装置劳动强度较小，在手术过程中始终能够更好地了解套管尖端的位置。
手术时间平均为 1 小时 40 分钟。平均插入的脂肪量为 1003cc。并发症包括供区血清肿、感染和 1 例经抗凝治疗的肺栓塞。无脂肪栓塞或死亡病例。
膨胀振动脂肪填充术是一种大容量脂肪移植的新方法。避免致命的脂肪栓塞需要外科医生在手术过程中始终完全了解套管尖端的位置。无注射器、较大口径和较不灵活的套管，以及需要较少手术上肢用力的技术，从而减少疲劳，可能有助于避免这种可怕的并发症。
临床问题/证据水平：治疗，IV。
