Youssef, M., Hussein, H., El Barbary, A., Ghanim, M. (2020). Assessment of Fat Grafting in Enhancing the Middle Eastern Buttocks. The Egyptian Journal of Plastic and Reconstructive Surgery, 44(4), 463-477. doi: 10.21608/ejprs.2020.140012
Mohamed Youssef; Heba Hussein; Amir El Barbary; Mohamed Abdel Mohsen Ghanim. "Assessment of Fat Grafting in Enhancing the Middle Eastern Buttocks". The Egyptian Journal of Plastic and Reconstructive Surgery, 44, 4, 2020, 463-477. doi: 10.21608/ejprs.2020.140012
Youssef, M., Hussein, H., El Barbary, A., Ghanim, M. (2020). 'Assessment of Fat Grafting in Enhancing the Middle Eastern Buttocks', The Egyptian Journal of Plastic and Reconstructive Surgery, 44(4), pp. 463-477. doi: 10.21608/ejprs.2020.140012
Youssef, M., Hussein, H., El Barbary, A., Ghanim, M. Assessment of Fat Grafting in Enhancing the Middle Eastern Buttocks. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 44(4): 463-477. doi: 10.21608/ejprs.2020.140012
Assessment of Fat Grafting in Enhancing the Middle Eastern Buttocks
The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Fat survival remains a challenge following fat grafting and has been a subject of debate. The key to successful fat grafting in buttock enhancement dictates familiarity with the technique, knowledge of the gluteal topography and aesthetics along with understanding of the patient's desired needs and goals. However, several areas still need to be researched. Objectives: This study aims to describe the anthropometric measurements of the Middle Eastern female buttocks and to evaluate the post-operative volume changes of structural fat grafting following gluteal enhancement procedures. Methods: This study included sixty adult healthy females. Candidates were classified into four main groups; control group (30 candidates) for measuring anthropometrics of Middle Eastern buttocks with normal BMI, and other 30 candidates were grouped into three surgical groups (10 candidates for each) according to the amount of fat grafting. Anthropometric measurements were obtained directly through patients' photos (posterior and lateral views) pre-operatively, 3 and 6 months postoperatively. Pre-operative volume of gluteal region in each quadrant was measured for the whole buttock by using the ultrasound then compared to that of 3 and 6 months post-operatively. Results: Control group (30 candidates) showed that round shape buttocks was the dominant shape. Fat survival rate of fat injected in subcutaneous plane decreased with increasing volume of fat injected, while in the intramuscular plane the survival rate the same and was not affected significantly. Conclusion and Recommendations: Round shaped buttock is the dominant shape in Middle Eastern buttock; fat survival rate is greater when injected intramuscular. We warn surgeons from trying intramuscular fat injection without anticipating problems and also without taking in consideration precautions and recommendations especially in large volume grafting. Also, we recommend authors to perform more studies in Middle Eastern buttocks for more control cases to confirm the anthropometric criteria of Middle Eastern buttocks.
1- Jorge Enrique Bayter-Marin, M.D. et al.: Understanding Fatal Fat Embolism in Gluteal Lipoinjection: A Review of the Medical Records and Autopsy Reports of 16 Patients PRS, 142 (5): 1198-1208, 2018. 2- Mendieta C.G.: Gluteoplasty. Aesthetic Surgery Journal, 23 (6): 441-55, 2003. 3- Pereira L.H. and Radwansky H.: Fat grafting of the buttock and lower limbs. Aesthetic Plast. Surg., 20: 409, 1996. 4- Mendieta C.G.: Classification system for gluteal evaluation. Clin. Plast. Surg., 33 (3): 333-46, 2006. Egypt, J. Plast. Reconstr. Surg., October 2020 477 5- Mofid M.M., Gonzalez R., de la Peña J.A., Mendieta C.G., Senderoff D.M. and Jorjani S.: Buttock augmentation with silicone implants: A multicenter survey review of 2226 patients. Plast. Reconstr. Surg., 131 (4): 897-901, 2013. 6- Ho Quoc, et al.: Ann. Chirp Last Esthat., 58 (3): 194-200, 2013. 7- Ford R.D. and Simpson W.D.: Massive extravasation of traumatically ruptured buttock silicone prosthesis. Ann. Plast. Surg., 29: 86, 1992. 8- American Society of Plastic Surgeons. 2016 plastic surgery statistics. Available at: https://www.plasticsurgery.org/ documents/ News/Statistics/2016/plastic-surgery-statisticsfullreport- 2016.pdf. Accessed January 13, 2018. 9- Mendieta C.G.: The Art of Gluteal Sculpting. New York: Thieme, 2011. 10- Mendieta C.G.: Intramuscular gluteal augmentation technique. Clin. Plast. Surg., 33 (3): 423-34, 2006. 11- Murillo W.L.: Buttock augmentation: Case studies of fat injection monitored by magnetic resonance imaging. Plast. Reconst. Surg., 114: 1606-1614, 2014. 12- Cardenas-Camarena L., Bayter J.E., Aguirre-Serrano H. and Cuenca-Pardo J.: Deaths caused by gluteal lipoinjection: What are we doing wrong? Plast. Reconstr. Surg., 136 (1): 58-66, 2015. 13- Abboud M.H. and Dibo S.A.: Immediate large-volume grafting of autologous fat to the breast following implant removal. Aesthet. Surg. J.., 35 (7): 819-829, 2015. 14- Mofid M.M., Teitelbaum S., Suissa D., Ramirez-Montanana A., Astarita D.C., Mendieta C., et al.: Report on mortality from gluteal fat grafting: Recommendations from the ASERF Task Force. Aesthet. Surg. J., 37 (7): 796-806, 2017. 15- Condé-Green A., Kotamarti V., Nini K.T., et al.: Fat Grafting for Gluteal Augmentation: A Systematic Review of the Literature and Meta-Analysis. Plast. Reconstr. Surg., 138 (3): 437e-446e, 2016. 16- Ramos-Gallardo G., Orozco-Renteria D., Medina-Zamora P., et al.: Prevention of fat embolism in fat injection for gluteal augmentation: Anatomic study in fresh cadavers. J. Invest. Surg., 31: 292-297, 2018. 17- International Society of Aesthetic Plastic Surgery. Available at: https://www.isaps.org/blog Accessed June 6, 2019