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Autologous fat injection for soft tissue augmentation in the face: a safe procedure?
D L Feinendegen1, R W Baumgartner, P Vuadens
1Department of Plastic & Reconstructive Surgery, Mount Vernon Hospital, Middlesex, England.
Aesthetic Plastic Surgery
|June 9, 1998
Summary
Autologous fat injections for facial augmentation can lead to serious complications like vision loss and stroke due to fat embolism. Performing injections slowly and avoiding pre-traumatized areas can minimize these risks.
Area of Science:
- Plastic Surgery
- Neurology
- Ophthalmology
Background:
- Autologous fat injection is a common procedure for facial soft tissue augmentation.
- While generally considered safe, rare but severe complications have been reported.
Observation:
- This report details two cases of ocular and cerebral embolism following facial fat injections.
- The mechanism involves intravasation of fat particles into vascular channels.
Findings:
- Key preconditions for intravasation include well-vascularized tissue, tissue fragmentation, and increased local pressure.
- Facial fat injections create these conditions, potentially leading to reversed flow into carotid artery branches.
- Manifestations of fat embolism can be immediate or delayed, and may be subclinical or misdiagnosed.
Implications:
- Slow injection technique and avoiding pre-traumatized tissues are crucial for risk mitigation.
- Metabolic factors like hyperlipidemia may increase risk.
- Routine funduscopic examinations could aid in future risk assessment for patients undergoing facial fat injections.
