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A Dynamic Anatomic Study of Parasacral Perforators: Mapping, Perforasome, and Applications for Buttock Enhancement
Gilles Claro1, Elise Lupon2, Farouk Dargai3
1Department of Plastic Surgery, University of Toulouse III Paul Sabatier, Toulouse, France.
Aesthetic Surgery Journal
|June 6, 2022
Summary
Detailed mapping of parasacral artery perforators reveals their density and distribution, enhancing the reliability of parasacral flaps for reconstructive and aesthetic surgery, particularly gluteal augmentation.
Area of Science:
- Anatomy
- Vascular Surgery
- Reconstructive Surgery
Background:
- Limited knowledge of parasacral artery perforators hinders confident use of flaps from this region.
- Understanding perforator clusters and perforasomes is crucial for designing reliable flaps.
Purpose of the Study:
- Identify the location, number, and density of parasacral artery perforators.
- Analyze their perfusion flow and linking vessel distribution.
Main Methods:
- Dissection of 5 fresh cadavers with latex injection of lateral sacral arteries.
- Mapping of perforators (>0.5 cm diameter) using a coordinate system.
- Radiopaque dye injection and 4D CT angiography for perforasome analysis.
Main Results:
- Identified an average of 8.4 perforators per cadaver (mean diameter 0.72 mm).
- Perforator density was highest near the midline, 7.6 cm above the iliac crests.
- Perfusion primarily targeted the superior gluteal region via diagonally oriented vessels.
Conclusions:
- Parasacral perforator flaps are valuable for reconstruction and aesthetic surgery, especially gluteal augmentation.
- Reliability hinges on precise anatomic knowledge and preoperative perforator mapping.
