Pazmiño Pat, Del Vecchio Daniel
Aesthet Surg J. 2023 Oct 13;43(11):1295-1306. doi: 10.1093/asj/sjad142.
Although the Brazilian butt lift (BBL) is one of the most popular procedures in body contouring, it has been associated with the risk of pulmonary fat embolism when fat graft is injected into the gluteal muscles. The subcutaneous plane has been identified as a safe site for fat graft injection, but deaths from fat embolism continue to occur because there is no mechanism to confirm consistent subcutaneous placement.
The aim of this paper was to determine if real-time intraoperative ultrasound could accurately identify the subcutaneous gluteal anatomic landmarks and permit a single surgeon to consistently target fat graft placement in the subcutaneous space.
In total, 4150 BBLs were performed with real-time intraoperative ultrasound being used to confirm the subcutaneous position of a static cannula during fat graft injection. Serial deposits of fat graft were performed in each buttock. Ultrasound confirmed that fat graft consistently remained above the deep gluteal fascia and migrated through the deep subcutaneous space. These fat graft deposits were then equalized with a moving cannula to correct any contour deformities. Operative times were recorded and compared with BBL performed by expansion vibration lipofilling without ultrasound.
Real-time intraoperative ultrasound allowed for the visual confirmation of consistent subcutaneous fat graft deposition and the targeting of fat graft into specific gluteal subcutaneous compartments.
Real-time intraoperative ultrasound allows the surgeon to confirm a subcutaneous-only fat graft injection, target specific gluteal subcutaneous compartments, and take advantage of the unique architecture of the deep subcutaneous space to create gluteal projection and correct contour deformities.
尽管巴西臀部提升术（BBL）是身体塑形中最受欢迎的手术之一，但当将脂肪移植到臀肌中时，它与肺脂肪栓塞的风险相关。皮下平面已被确定为脂肪移植注射的安全部位，但脂肪栓塞导致的死亡仍在发生，因为没有机制来确认脂肪始终放置在皮下。
本文的目的是确定术中实时超声是否能准确识别臀皮下解剖标志，并使单一外科医生能够始终将脂肪移植靶向放置在皮下空间。
总共进行了4150例BBL手术，术中使用实时超声来确认脂肪移植注射期间静态套管的皮下位置。在每个臀部进行系列脂肪移植注射。超声确认脂肪移植始终保持在臀深筋膜上方，并通过皮下深层空间迁移。然后用移动套管使这些脂肪移植注射均匀，以纠正任何轮廓畸形。记录手术时间，并与不使用超声的膨胀振动脂肪填充法进行的BBL手术进行比较。
术中实时超声可直观确认脂肪移植始终沉积在皮下，并将脂肪移植靶向特定的臀皮下腔隙。
术中实时超声可使外科医生确认仅在皮下进行脂肪移植注射，靶向特定的臀皮下腔隙，并利用皮下深层空间的独特结构来塑造臀部外形并纠正轮廓畸形。
