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      Lipoinjerto en gluteoplastia. ¿Es un procedimiento seguro? Translated title: Fat grafting in gluteoplasty. Is it a safe procedure?

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          Abstract

          Resumen Introducción y objetivo. La gluteoplastia de aumento con lipoinjertos es uno de los procedimientos estéticos más realizados en el mundo, sin embargo, dada su alta tasa de mortalidad frente a los demás procedimientos estéticos, durante la última década se han publicado varios estudios y artículos en busca de recomendaciones para reducir desenlaces fatales. Revisamos la literatura actual para identificar índices de mortalidad, consensuar las recomendaciones encontradas e identificar estudios cadavéricos que permitan cuestionar si este procedimiento es seguro y si las medidas tomadas hasta el momento son suficientes para la seguridad de los pacientes. Material y método. Revisión mediante búsqueda exhaustiva en bases de datos científicas de artículos en cuyo contenido hubiera datos sobre casos nuevos, fisiopatología de complicaciones mayores y menores y estrategias para prevenirlas. Resultados. Obtuvimos 11 documentos: boletines, artículos de revisión, reportes de caso, revisiones sistemáticas y estudios experimentales en cadáveres. Conclusiones. En la lipoinyección glútea, la inyección del lipoinjerto en planos submúsculares supone aumento del riesgo de presentación de complicaciones macroscópicas y microscópicas por la migración de grasa al torrente sanguíneo. A pesar de las múltiples recomendaciones ya establecidas, abogamos por el desarrollo de técnicas que permitan asegurar la lipoinyección en plano subcutáneo. Nivel de evidencia científica Terapéutico 5a

          Translated abstract

          Abstract Background and objective. Augmentation gluteoplasty with fat grafting is one of the most performed aesthetic procedures in the world, however, given its high mortality rate compared to other aesthetic procedures, during the last decade several studies and articles have been published in search of recommendations for reduce their fatal outcomes. We conduct a literature review in order to identify mortality rates, reach a consensus on the recommendations found, and identify cadaveric studies that may question whether this procedure is safe and whether the measures taken to date will be sufficient for patient safety. Methods. A review article was carried out through an exhaustive search in scientific databases, which included data on new reported cases, pathophysiology of major and minor complications and presented strategies. prevention of these complications. Results. A total of 11 documents were obtained, among which we found bulletins, review articles, case reports, systematic reviews, and experimental studies in cadavers. Conclusions. In gluteal lipoinjection, the injection of the lipograft in submuscular planes implies an increased risk of macroscopic and microscopic complications of fat migration through the bloodstream. Despite the multiple recommendations already established, we advocate the development of techniques that allow graft injection to be ensured subcutaneously. Level of evidence Therapeutic 5a

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          Most cited references11

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          Improvement in Brazilian Butt Lift (BBL) Safety With the Current Recommendations from ASERF, ASAPS, and ISAPS

          In 2017, the ASERF Gluteal Task Force reported gluteal fat grafting to be a high-risk procedure and recommended specific surgical techniques to decrease the risk of pulmonary fat embolism (PFE). To determine if ASAPS and ISAPS members were aware of the 2017 recommendations, what their current surgical techniques were, if they had changed their techniques based on the 2017 recommendations, and whether the incidence of PFEs had changed since the recommendations were published. An anonymous web-based survey was conducted among members of ASAPS and ISAPS. It included the questions from the 2017 survey, as well as, questions about awareness of the Task Force recommendations and subsequent change in surgical techniques. In the two years following the publication of the recommendations, the incidence of any PFE was 1/2492 compared to 1/1,030 reported in 2017 (p=0.02). Trends indicated a decreased mortality rate from 1/3,448 in 2017 to 1:14,952 in 2019. Ninety-four percent of respondents were aware of the recommendations. Only 0.8% of surgeons in the current survey reported injecting in deep muscle compared to 13.1% in 2017 (p<0.01). Compared to 4.1% in 2017, 29.8% of respondents in our survey reported using cannulas ≥4.1 mm only (p<0.01). Only 4% of respondents reported angling the cannula down in the current survey compared to 27.2% in 2017 (p<0.01). It appears members were aware of the 2017 recommendations. There was a significant decrease in recent PFE and trends showed a change to safer techniques and improvement in safety of the procedure.
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            Critical Differences between Microscopic (MIFE) and Macroscopic (MAFE) Fat Embolism during Liposuction and Gluteal Lipoinjection

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              The Role of Fat Grafting in Buttock Augmentation

              Autologous fat grafting is now considered the gold standard for buttock augmentation. Although a variety of techniques are currently being used by surgeons around the world, methods of fat grafting to the buttocks remain unsystematized, poorly understood, and controversial in terms of their safety and efficacy. Nonetheless, buttock augmentation by fat grafting has a satisfaction rate of 97.1%, and its mean complication rate has been estimated to be around 7 to 10%, with serious complications occurring in less than 1% of cases. Fat emboli are one such serious complication, with several reports in the literature discussing morbidity and mortality, specifically with intramuscular injection. With the increasing popularity of fat grafting for buttock augmentation, it is more important than ever to continue researching and learning to safeguard the satisfaction and safety of our patients.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                March 2023
                : 49
                : 1
                : 53-60
                Affiliations
                [2] Bogotá Bogotá orgnameUniversidad Militar Nueva Granada Colombia
                [1] Bogotá Bogotá orgnameUniversidad Militar Nueva Granada orgdiv1Hospital Militar Central Colombia
                [3] Bogotá Bogotá orgnameUniversidad Militar Nueva Granada orgdiv1Hospital Militar Central Colombia
                Article
                S0376-78922023000100008 S0376-7892(23)04900100008
                10.4321/s0376-78922023000100008
                2052adfe-5010-46d5-acc5-edfdedcd9430

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 30 September 2022
                : 07 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 8
                Product

                SciELO Spain

                Categories
                Estética

                Augmentation gluteoplasty,Gluteal fat grafing,Gluteal fat transfer,Fat embolism,Gluteoplastia de aumento,Lipoinjerto glúteo,Lipotransferencia glútea,Embolismo graso

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