Massachusetts General Hospital, Boston, MA, USA.
Betty and Warren Woodward Chair, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Aesthet Surg J. 2022 Aug 24;42(9):1019-1029. doi: 10.1093/asj/sjac082.
On January 31, 2018, The Multi-Society Task Force for Safety in Gluteal Fat Grafting released a practice advisory regarding gluteal fat grafting. The task force was assembled in the wake of several highly publicized patient deaths involving Brazilian Butt Lift (BBL) and produced a second practice advisory in August 2019. In 2021, The Aesthetic Surgery President commissioned a Working Group on BBL Patient Safety, charging the group to address new guidelines affecting safety and welfare of BBL patients. The "Practice Advisory on Gluteal Fat Grafting" is the first advisory developed since the working group was formed. In addition to surgical technique as a major cause of fatal complications of BBL, the working group focused on micro-economic trends of operative time and regional BBL pricing and considered fatigue and distraction in formulating the current guidelines. In Florida, the majority of BBL deaths occur at the end of the week. Such a non-normalized distribution most likely represents the result of fatigue and/or distraction, which has been linked to surgical mortality in multiple published communications. In addition, mortality is likely due to uncertainty or lack of documentation as to the correct plane of fat injection. Therefore, the newest and most compelling recommendations from these guidelines include the utilization of ultrasound-guided documentation of cannula placement prior to and during fat injection, and the limitation of 3 BBL cases as a maximum amount of total operative cases per day. The authors thank members of the task force for the insights they brought to this process.
2018 年 1 月 31 日，安全臀脂移植多学会工作组发布了关于臀脂移植的实践指南。该工作组是在几起涉及巴西臀提升术（BBL）的高知名度患者死亡事件后成立的，并于 2019 年 8 月发布了第二份实践指南。2021 年，美容外科学会主席委托一个 BBL 患者安全工作组，要求该小组制定新的指南，以影响 BBL 患者的安全和福利。“臀脂移植实践指南”是该工作组成立以来发布的第一份指南。除了手术技术是 BBL 致命并发症的主要原因外，工作组还重点关注手术时间和地区 BBL 定价的微观经济趋势，并考虑了疲劳和注意力分散在制定当前指南中的作用。在佛罗里达州，大多数 BBL 死亡发生在周末。这种非正态分布很可能是疲劳和/或注意力分散的结果，这在多个已发表的通讯中与手术死亡率有关。此外，死亡率可能是由于不确定或缺乏关于正确脂肪注射平面的文件记录。因此，这些指南中最新和最有力的建议包括在脂肪注射前和注射过程中使用超声引导记录套管放置，以及每天最多进行 3 例 BBL 手术的限制。作者感谢工作组的成员为这一过程提供的见解。
