Facial Fat Necrosis After Autologous Fat Grafting Caused by Cellulitis: A Case Report

Autologous fat grafting is a widely used soft tissue filling technique for facial rejuvenation, favored for its high biocompatibility and long-lasting effects. However, the long-term risk of infection due to alterations in local tissue structure remains unclear. This article reports a case of perforating cellulitis in the frontotemporal region of a 39-year-old female patient 3 years after multiple autologous fat grafting procedures. The patient, with no significant prior medical history or immune compromise, developed sudden redness and swelling in the right temporal region, which rapidly spread to the forehead and left temporal region, resulting in perforating abscesses and fat liquefaction necrosis at the filling sites. Laboratory tests identified Staphylococcus aureus as the causative pathogen. The patient was successfully treated with intravenous ceftriaxone sodium and surgical drainage, achieving full recovery with no recurrence during a 6-month follow-up. This case highlights that repeated subcutaneous fat grafting may loosen tissue structure, potentially increasing susceptibility to infection spread. It underscores the importance of vigilance for delayed infections in patients with a history of cosmetic procedures, even years post-operation. Clinicians should consider aesthetic fillings as a possible risk factor for cellulitis and prioritize prompt pathogen identification and aggressive treatment. The findings emphasize the need for long-term monitoring and further research into infection mechanisms post-aesthetic surgery to enhance procedural safety.