From the Department of Surgery, Division of Plastic and Reconstructive Surgery, David Geffen UCLA School of Medicine; Ghavami Plastic Surgery; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2018 Aug;142(2):363-371. doi: 10.1097/PRS.0000000000004588.
The number of buttock augmentations with fat transfer is steadily increasing, but a number of fatalities caused as a direct result of gluteal fat grafting have been reported. The technical details relating to cannula size, injection angle or trajectory, and plane of injection are critical for avoiding morbidity and mortality. However, the ligamentous anatomy has not been thoroughly explored, particularly how the ligaments are encountered in the clinical setting of fat transfer by means of cannulas.
The gluteal regions of five fresh cadavers were dissected, for a total of 10 hemidissections. All pertinent cutaneous ligaments in the region were identified. In addition, cannulas were used to simulate typical variations in injection planes.
The osseocutaneous and fasciocutaneous ligaments of the buttocks were identified.
The authors describe important ligamentous structures consistently found in the region in cadaveric dissections and discuss the implications while safely performing gluteal augmentation. The anatomical features, boundaries, and soft-tissue attachment points may play a role in cannula-directed fat injection misguidance. The ligaments, when not released, can lead to undesired deep injection and therefore fat lobule migration into the venous system. The density, danger zones, and soft-tissue attachments must be clarified further as we continue to offer our patients improved buttock contour with a higher safety profile.
随着脂肪转移丰臀术数量的稳步增加，已有多起因臀脂肪移植而直接导致的死亡病例报告。在避免发病率和死亡率方面，与管腔大小、注射角度或轨迹以及注射平面相关的技术细节至关重要。然而，韧带解剖结构尚未得到彻底探索，尤其是在通过管腔进行脂肪转移的临床环境中，韧带是如何遇到的。
对 5 具新鲜尸体的臀部进行解剖，总共进行了 10 次半解剖。确定了该区域所有相关的皮肤韧带。此外，还使用了套管来模拟典型的注射平面变化。
识别出臀部的骨皮和筋膜皮韧带。
作者在尸体解剖中描述了在该区域始终存在的重要韧带结构，并讨论了在安全进行臀部增强时的影响。解剖特征、边界和软组织附着点可能会在管腔引导的脂肪注射中起误导作用。如果不释放韧带，可能会导致不希望的深部注射，从而导致脂肪小叶迁移到静脉系统中。随着我们继续为患者提供更高安全性的改善臀部轮廓，密度、危险区域和软组织附着点必须进一步阐明。
