Ahmed Elsaftawy, Michał Bonczar, Marta Jagosz, Tomasz Bonczar, Paweł Stajniak, Tomasz Główka, Patryk Ostrowski
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引用次数: 0
Abstract
Background: Fat grafting has become one of the most widely used methods for gluteal augmentation, yet concerns remain regarding its safety and complication profile. This study aims to update and synthesize complication rates associated with gluteal fat grafting, with a particular focus on procedural factors.
Methods: A systematic search through PubMed, Embase, Scopus, and Cochrane Library was conducted following PRISMA guidelines. Original clinical studies reporting complications following autologous fat grafting for gluteal augmentation were included.
Results: A total of 38 studies comprising 22,151 patients were included. The pooled incidence of minor complications was 3.58% (95% CI: 1.75-5.99%), with seromas occurring in 2.03% and contour irregularities in 2.29% of cases. Pulmonary embolism had a pooled incidence of 0.04%. Ultrasound-guided fat grafting was associated with lower rates of both major (0.02% vs. 0.08%) and minor (2.82% vs. 3.70%) complications. Subcutaneous-only injection planes demonstrated the lowest complication rates compared to intramuscular or combined approaches. The use of lipoaspirate additives and drains did not consistently lower complication rates and was sometimes associated with increased adverse outcomes.
Conclusions: Fat grafting is generally safe when performed using evidence-based techniques. Subcutaneous-only injection and ultrasound guidance are associated with improved outcomes and may enhance procedural safety. Continued research with prospective, standardized studies is necessary to refine procedural strategies and minimize complication risks.
背景：脂肪移植已成为最广泛使用的臀肌增大方法之一，但其安全性和并发症仍然令人担忧。本研究旨在更新和综合与臀脂肪移植术相关的并发症发生率，并特别关注手术因素。方法：根据PRISMA指南，通过PubMed、Embase、Scopus和Cochrane Library进行系统检索。原始临床研究报告了自体脂肪移植术后臀肌增大的并发症。结果：共纳入38项研究，包括22151例患者。轻微并发症的总发生率为3.58% (95% CI: 1.75-5.99%)，血清肿发生率为2.03%，轮廓不规则发生率为2.29%。肺栓塞的总发生率为0.04%。超声引导下的脂肪移植的主要并发症发生率（0.02% vs 0.08%）和次要并发症发生率（2.82% vs 3.70%）均较低。与肌肉注射或联合入路相比，单纯皮下注射的并发症发生率最低。使用吸脂剂添加剂和引流管并不能始终降低并发症发生率，有时还会增加不良后果。结论：采用循证技术进行脂肪移植通常是安全的。仅皮下注射和超声引导与改善预后相关，并可提高手术安全性。有必要继续进行前瞻性、标准化的研究，以完善手术策略并将并发症风险降至最低。
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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