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- W2883016148 abstract "Sir: We thank Dr. Sisti and colleagues for their interest and Letter to the Editor regarding our article “Staying Safe during Gluteal Fat Transplantation.”1 We agree that their findings and those in the study by Ramos-Gallardo et al. are in accordance with the safety triangle we have highlighted as the zone of greatest potential danger, where the major gluteal vessels and sciatic nerve are found.2 Within the safety triangle, it is imperative that fat transplantation occurs in the subcutaneous plane. However, our recommendation is to remain superficial within the subcutaneous plane throughout the gluteal augmentation procedure. Therefore, the angle of approach to the gluteal muscle is not pertinent because the angle should be selected to completely avoid injection into the gluteal muscle. Gluteal fat transplantation into the subcutaneous plane only may improve the safety profile of this procedure, as there is no opportunity for damage to intragluteal vessels. Furthermore, Dr. Del Vecchio recently presented at the 52nd Annual Baker Gordon Symposium and will soon publish our findings in a cadaveric study demonstrating that any injection below the muscular fascia can lead to deep intramuscular migration of the fat, which leads the transplanted fat to deposit directly over the gluteal vessels and sciatic nerve submuscularly.3 Deep intramuscular migration therefore increases the danger profile of any intramuscular injection regardless of angle and should therefore be avoided. DISCLOSURE Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Thieme Publishing. No funding was received for this article. Dr. Del Vecchio is a founder of Surgistem Technologies, LLC, a device company involved in fat transplantation; receives royalties from Microaire; and is a founding member of Penninsula Partners, LLC a consulting firm in the plastic surgery sector. Dr. Villanueva and Dr. Afrooz have no financial interest to declare in relation to the content of this communication. Nathaniel L. Villanueva, M.D.Department of Plastic SurgeryUniversity of Texas Southwestern Medical CenterDallas, Texas Daniel A. Del Vecchio, M.D.Back Bay Plastic SurgeryBoston, Mass. Paul N. Afrooz, M.D.Rod J. Rohrich, M.D.Dallas Plastic Surgery InstituteDallas, Texas" @default.
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- W2883016148 date "2018-10-01" @default.
- W2883016148 modified "2023-09-26" @default.
- W2883016148 title "Reply" @default.
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- W2883016148 doi "https://doi.org/10.1097/prs.0000000000004789" @default.
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