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In-Vivo Study of Gluteal Vein Caliber & Anatomy to Improve Safety in Gluteal Augmentation Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: John Y.S. Kim, MD

Grant Award: ASERF Interim Grant

Amount Awarded: $20,600

Project Name: In-Vivo Study of Gluteal Vein Caliber & Anatomy to Improve Safety in Gluteal Augmentation

Project Summary: Fat grafting for gluteal augmentation has become a very popular procedure. Unfortunately, there have been a number of deaths due to fat emboli associated with this surgery. The root cause is hypothesized to be laceration of the gluteal veins in the deep submuscular plane, allowing the surrounding fat graft to enter the lumen. This event is rare, and practitioners (both board-certified plastic surgeons as well as other medical professionals) continue to perform the procedure. Our goal is to improve the safety of the procedure by examining the gluteal vein.

The specific aims of this study are to conduct an in-vivo evaluation of gluteal veins and their large tributaries in different body positions (prone, supine, lateral decubitus) using MRI to determine whether positioning has any significant effect on their caliber. We also aim to describe the locations of the large tributaries and the course of the main trunks of the gluteal veins in relation to the bony landmarks to assist in avoiding these structures during large-volume gluteal lipofilling.

We hypothesize that lateral decubitis positioning may be associated with a decrease in gluteal vein caliber for the non-dependent side.

We have already completed data acquisition to map the caliber and location of the large gluteal veins in a series of 10 patients who had previously undergone MRI in the supine position. While data on the relative sizes of the branches and their locations should be accurate, the absolute caliber measurements are likely to be confounded by the supine positioning. There, this child study will allow us to accurately measure both the caliber of the gluteal veins in the surgical position as well as the changes in their size with position changes.

 

 
Correlating Technique with Proximity to Anatomic Danger Zones in Gluteal Fat Transfer: A Patient Safety Study Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Peter Rubin, MD

Grant Award: ASERF Interim Grant

Amount Awarded: $115,100

Project Name: Correlating Technique with Proximity to Anatomic Danger Zones in Gluteal Fat Transfer: A Patient Safety Study

Project Summary: Gluteal fat grafting is growing in popularity. Along with this rise in case numbers, serious safety issues are evolving, with morbidity and mortality publicized in the media. Although gluteal fat grafting (GFG) has been performed for decades without safety concerns raised, recent expansion in case volume broadened the cohort of surgeons performing this procedure.  Moreover, clinicians not trained in plastic surgery are performing GFG. A recent published study by the ASERF task force suggests that the rate of mortality from GFG may be many times higher than other plastic surgery procedures. Autopsy findings indicate that the key technical problem is fat graft material entering major blood vessels, including the iliac veins. This proposal by the Multi-Society Gluteal Fat Grafting Task Force, seeks to mitigate the risk of the procedure through key anatomic studies and education of plastic surgeons. Our central hypothesis is that safe approaches for buttock fat grafting can be delineated by modeling the operation in cadavers. 

Aim 1: Determine proximity to iliac veins and gluteal venous trunks with varying cannula angles from common incision/port sites.

Aim 2: Model the operation in the same 5 cadavers with 5 experienced buttock fat grafting surgeons.

Aim 3: Create an educational tool to teach the safety lessons obtained from the study and make it available through a central portal. 

Impact:  This work will directly impact patient safety by mapping safe and dangerous cannula approaches during gluteal fat grafting, and creating a strong educational program for plastic surgeons.

 
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