Integrated Management of Mycobacterium abscessus Infections Following Aesthetic Fat Grafting: A Promising Combination...

Infections caused by nontuberculous mycobacteria (NTM), particularly Mycobacterium abscessus, represent rare but increasingly reported complications following cosmetic fat transplantation. However, standardized and effective treatment protocols remain underexplored. This study aimed to evaluate the efficacy of anti-tuberculosis (anti-TB) medication combined with local vacuum aspiration in treating multiple wound infections caused by Mycobacterium abscessus complex following autologous fat transplantation.

Between June 2017 and June 2019, 10 patients with M. abscessus complex infection after autologous fat grafting were enrolled, involving a total of 70 infected wounds (31 facial, 32 breast, and 7 thigh sites). Prior to minimal-incision open debridement, ultrasound localization was performed. Necrotic granulation tissue was thoroughly curetted, followed by vacuum sealing drainage (VSD) with continuous aspiration. Irrigation and drainage tubes were subsequently placed to promote granulation tissue formation. All patients received standardized anti-TB drug therapy.

During a follow-up period ranging from 8 to 16 months (mean: 12 months), all 70 wounds in the 10 enrolled patients achieved satisfactory healing in terms of both deep tissue repair and superficial appearance. No recurrence of infection was observed throughout the follow-up period. Wound closure was accomplished without the need for additional surgical reconstruction in all cases. The combination of anti-TB chemotherapy and vacuum aspiration consistently promoted granulation tissue formation and controlled local inflammation, leading to functionally and cosmetically acceptable outcomes across all anatomical sites, including face, breast, and thigh regions.

The combination of minimal-incision debridement, local vacuum aspiration, and anti-TB medication provides an effective and practical treatment for M. abscessus infections secondary to autologous fat grafting. This integrated approach is recommended for managing such challenging postoperative infections.

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