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Purpose: Breast augmentation is the most commonly performed aesthetic operation in the Unites States annually. With the increasing popularity of gel implants, optimal incisional length for specific implant volumes becomes a factor to consider. Our study is the first, to date, to measure optimal incisional length for increasing Mentor smooth, round, moderate plus silicone implant volumes. Method: Three cadaver breasts were dissected in our anatomy laboratory. After dissection of a subpectoral pocket via an inframammary fold incision, time of implant insertion was measured for increasing volumes with the use of increasing incisional site lengths. Results: Values for increased incisions are as follows: 2.5-cm incision facilitated 100-cm3 implant (average time [AvgT] 76 seconds); 3-cm incision 100-cm3 implant (AvgT 32 seconds), 200 cm3 (AvgT 84.33 seconds); 3.5-cm incision 100-cm3 implant (AvgT 13.00 seconds), 200 cm3 (AvgT 22.00 seconds), 300 cm3 (AvgT 33.67 seconds); 4-cm incision 100-cm3 implant (AvgT 5.67 seconds), 200 cm3 (AvgT 11.33 seconds), 300 cm3 (AvgT 21.33 seconds), 400 cm3 (AvgT 26 seconds); 4.5-cm incision 100-cm3 implant (AvgT 5 seconds), 200 cm3 (AvgT 15.17 seconds), 300 cm3 (AvgT 19.67 seconds), 400 cm3 (AvgT 26 seconds), 500 cm3 (AvgT 39.67 seconds), 600 cm3 (AvgT 59.33 seconds), 700 cm3 (AvgT 78.67 seconds); 5-cm incision 100-cm3 implant (AvgT 1 second), 200 cm3 (AvgT 3.67 seconds), 300 cm3 (AvgT 8 seconds), 400 cm3 (AvgT 13 seconds), 500 cm3 (AvgT 19.33 seconds), 600 cm3 (AvgT 23.33 seconds), 700 cm3 (AvgT 28 seconds), 800 cm3 (AvgT 33 seconds). Conclusion: Based on our results, the optimal incision size for increasing Mentor smooth, round, moderate plus volumes is as follows: 2.5 cm for 100-cm3 implant, 3 cm for 200-cm3 implant, 3.5 cm for 300-cm3 implant, 4 cm for 400-cm3 implant, 4.5 cmfor 500- to 700-cm3 implant, and 5 cm for 800-cm3 implant. This guideline can be used to provide the most aesthetic results without tissue compromise. [ABSTRACT FROM AUTHOR]

Objective: The increase in demand for gluteal fat grafting seen in recent years in the United States has not been met with an equal gain in knowledge of the perils of this anatomic territory. The purpose of this study was to identify anatomic landmarks that can be readily used by surgeons to identify the takeoff of the superior and inferior gluteal veins. Method: Six fresh cadaveric gluteal specimens were dissected at the University of Louisville anatomy laboratory. A question mark incision was made for exposure, followed by identification of the sciatic nerve in the proximal thigh. This was traced retrograde to the sciatic forearm. The piriformis muscle was identified dividing the foreman into superior and inferior portions, which corresponded to the takeoff of the superior and inferior gluteal vessels, respectively. The distance of the gluteal vessels from the one-third point of a line from the mid-sacrum to the greater trochanter was measured. Result: Our cadaveric dissection series demonstrated that the superior and inferior gluteal veins were on average 3.28 cm (2-5.9 cm) and 1.25 cm (0-3.5 cm) away from the point one third the distance from the mid-sacral border to the greater trochanter. Conclusion: Themid-sacrumand the trochanter of the femur are the anatomic landmarks used to identify the large gluteal vein trunks. Understanding the location and trajectory of these deep gluteal structures with use of readily identifiable landmarks may assist surgeons in avoiding inadvertent injection of fat to these veins during fat grafting. [ABSTRACT FROM AUTHOR]