Fat Grafting and Fat Embolism. How to Prevent, Diagnose, and Treat

Abstract

Autologous fat transfer is one of the most frequently done procedures, either as a single procedure or in combination with other procedures, in aesthetic, reconstructive, and regenerative surgery. Fat grafting is shown to be safe through many studies but it can rarely cause severe complications like fat embolism. Newer reports that studied sudden death after gluteal augmentation with fat showed that fat embolism has two forms depending on the amount of fat that enters the bloodstream, as well as the size of fat droplets: Microscopic (MIFE) and macroscopic (MAFE) fat embolism. MIFE has a clinical presentation that matches the characteristics of the traditionally known fat embolism syndrome, whereas MAFE causes a state that mostly resembles a massive pulmonary thromboembolism and has a poor prognosis. Both forms of fat embolization occur as a result of fat particles entering the blood stream, but their clinical presentations, prevention, treatment and prognoses are completely different. A quick diagnosis and start of treatment are key for a positive outcome. Selection of an eligible patient, the selection of a safe region, correct performing of the procedure and excellent knowledge of anatomy are of great importance in prevention of a fat embolism. © Springer Nature Switzerland AG 2022.