Autologous Fat Transfer Procedure Complications in Four Emergency Departments in Miami, Florida

Our study objective was to share the experiences of four public emergency departments (ED) caring for patients with complications of gluteal autologous fat transfer (AFT), colloquially known as Brazilian butt lifts, to provide emergency physicians with a better understanding of these patients and potential complications associated with the procedure.

Jackson Health System in Miami, Florida, undertook an institutional initiative to prospectively collect data on patients presenting to any of the system's EDs with gluteal AFT complications from October 2020-May 2023. We abstracted patient charts for demographics, disposition, lab values, diagnoses, and care-related charges to generate descriptive statistics. Our primary outcome measure was diagnostic code and diagnostic category. Secondary outcome measures were hemoglobin on presentation, units of blood transfused, admission level of care, hospital charge, length of stay, and mortality.

Of 234 potentially relevant patient charts identified by our hospital protocol, 157 patients met our criteria. All were female, with an average age of 33. A total of 123 patients were from out of state, and one was international. The most common diagnoses were anemia/bleeding (81 patients), followed by pain (65), cardiac (36) and hypovolemia/dehydration (32). Our analysis revealed that 86 patients presenting to the ED required admission (54.8%), with 12 patients requiring intensive care unit care (7.6%). There was one death (0.6%). Total hospital charges for this cohort equaled $2,822,540, averaging $17,977 per patient.

Gluteal AFT procedures are associated with a wide range of complications, morbidity, and mortality. These patients have a high admission rate and the potential to be critically ill. Patients travel from around the country to have these procedures performed, and it is crucial that EDs nationally are prepared to care for them.