Assessment of the Risk of Systemic Fat Mobilization and Fat Embolism as a Consequence of Liposuction: Ex Vivo Study

El-Ali, K.; Gourlay, Terence

doi:10.1097/01.prs.0000218715.58016.71

Cited by 42 publications

(31 citation statements)

References 20 publications

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“…It was observed that increasing the number of fat globules is directly related to the time of liposuction 11 . In our study, the liposuction procedure was performed on all animals at time of less than 10 minutes with removal of 8 ml of adipose tissue per animal, contrasting with the 60 minutes cited in other studies 11,12 . The lack of finding may also be attributed to the minimally invasive nature of the technique and choice for reduced surgical time.…”

Section: Discussionmentioning

confidence: 99%

“…Experimental studies involving liposuction procedures shows techniques more harmful and long duration [11][12][13] . This difference may interfere considerably in the outcome.…”

Section: Discussionmentioning

confidence: 99%

“…In a study with rats undergoing liposuction, embolic event occurred in blood samples of experimental groups intraoperatively at 30 end 60 minutes 11 . It was observed that increasing the number of fat globules is directly related to the time of liposuction 11 .…”

Section: Discussionmentioning

confidence: 99%

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Fat embolism in liposuction and intramuscular grafts in rabbits

Felzemburgh

Barbosa²,

Nunes³

et al. 2012

Acta Cir. Bras.

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PURPOSE:To evaluate the effects of fat embolism in organs such as lung and liver. METHODS:Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. RESULTS:The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION:The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.Key words: Embolism, Fat. Lipectomy. Ischemia. Rabbits. RESUMOOBJETIVO: Avaliar a repercussão da embolia gordurosa em órgãos como pulmão e fígado. MÉTODOS:Vinte coelhos foram submetidos à enxertia autóloga intramuscular de gordura em coxa direita após lipoaspiração. Os grupos foram determinados conforme os dias pós-operatórios (DPO) em que ocorreu a eutanásia: 60 DPO, 90DPO, 120 DPO. Em seguida, o pulmão e o fígado foram ressecados e encaminhados ao laboratório de histopatologia para análise em busca de lesão tardia secundária a evento de embolia gordurosa prévia nos tecidos. RESULTADOS:Foi evidenciada uma alteração na amostra a analise macroscópica com alteração da coloração do tecido hepático de forma heterogênea. Não houve alterações compatíveis com repercussão de processo embólico à microscopia. CONCLUSÃO:A opção pela realização de uma técnica de lipoenxertia menos traumática e com pequeno tempo cirúrgico pode ser considerada protetora para eventos embólicos, não havendo repercussão embólica a tardiamente.Descritores: Embolia Gordurosa. Lipectomia. Isquemia. Coelhos.Felzemburgh VA et al.

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Section: Discussionmentioning

confidence: 99%

“…Experimental studies involving liposuction procedures shows techniques more harmful and long duration [11][12][13] . This difference may interfere considerably in the outcome.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fat embolism in liposuction and intramuscular grafts in rabbits

Felzemburgh

Barbosa²,

Nunes³

et al. 2012

Acta Cir. Bras.

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“…(4) However, reports of adverse consequences, among which are fat embolism and FES, are increasingly common. (2)(3)(4)6) Fat embolism is defined as the occurrence of mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin.…”

Section: Discussionmentioning

confidence: 99%

“…(1) More rarely, there are reports of FES after cosmetic procedures, such as liposuction and fat grafting. (2)(3)(4) In the lungs, fulminant FES manifests as severe respiratory insufficiency and acute respiratory distress syndrome (ARDS), although the emboli can reach the arterial circulation and affect other sites, such as the central nervous system, retina, and skin. (2,3) rial oxygen tension/fraction of inspired oxygen ratio of 32 and a lung injury score of 2.6.…”

Section: Introductionmentioning

confidence: 99%

Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia

et al. 2008

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Fat embolism is defined as mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin. Fat embolism syndrome is a dysfunction of these organs caused by fat emboli. The most common causes of fat embolism and fat embolism syndrome are long bone fractures, although there are reports of its occurrence after cosmetic procedures. The diagnosis is made clinically, and treatment is still restricted to support measures. We report the case of a female patient who developed adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. In this case, the patient responded well to alveolar recruitment maneuvers and protective mechanical ventilation. In addition, we present an epidemiological and pathophysiological analysis of fat embolism syndrome after cosmetic procedures. Keywords:Respiratory distress syndrome, adult; Embolism, fat; Lipectomy. ResumoA embolia gordurosa é definida como a ocorrência de bloqueio mecânico da luz vascular por gotículas circulantes de gordura. Acomete principalmente o pulmão, podendo afetar também o sistema nervoso central, a retina e a pele. A síndrome da embolia gordurosa é uma disfunção desses órgãos causada pelos êmbolos gordurosos. As causas mais comuns de embolia gordurosa e síndrome da embolia gordurosa são as fraturas de ossos longos, mas há relatos de sua ocorrência após procedimentos estéticos. O diagnóstico é clínico, e o tratamento ainda se restringe a medidas de suporte. Apresentamos o caso de uma paciente que evoluiu com síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia e respondeu bem às manobras de recrutamento alveolar e à ventilação mecânica protetora.Apresentamos também uma análise epidemiológica e fisiopatológica da síndrome da embolia gordurosa após procedimentos estéticos.Descritores: Síndrome do desconforto respiratório do adulto; Embolia gordurosa; Lipectomia.* Study carried out in the

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Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler Injections

et al. 2014

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for the Korean Retina Society IMPORTANCE Iatrogenic occlusion of the ophthalmic artery and its branches is a rare but devastating complication of cosmetic facial filler injections.OBJECTIVE To investigate clinical and angiographic features of iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections. DESIGN, SETTING, AND PARTICIPANTS Data from 44 patients with occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections were obtained retrospectively from a national survey completed by members of the Korean Retina Society from 27 retinal centers. Clinical features were compared between patients grouped by angiographic findings and injected filler material. MAIN OUTCOMES AND MEASURESVisual prognosis and its relationship to angiographic findings and injected filler material.RESULTS Ophthalmic artery occlusion was classified into 6 types according to angiographic findings. Twenty-eight patients had diffuse retinal and choroidal artery occlusions (ophthalmic artery occlusion, generalized posterior ciliary artery occlusion, and central retinal artery occlusion). Sixteen patients had localized occlusions (localized posterior ciliary artery occlusion, branch retinal artery occlusion, and posterior ischemic optic neuropathy). Patients with diffuse occlusions showed worse initial and final visual acuity and less visual gain compared with those having localized occlusions. Patients receiving autologous fat injections (n = 22) had diffuse ophthalmic artery occlusions, worse visual prognosis, and a higher incidence of combined brain infarction compared with patients having hyaluronic acid injections (n = 13).CONCLUSIONS AND RELEVANCE Clinical features of iatrogenic occlusion of the ophthalmic artery and its branches following cosmetic facial filler injections were diverse according to the location and extent of obstruction and the injected filler material. Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction. Extreme caution and care should be taken during these injections, and physicians should be aware of a diverse spectrum of complications following cosmetic facial filler injections.

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Assessment of the Risk of Systemic Fat Mobilization and Fat Embolism as a Consequence of Liposuction: Ex Vivo Study

Abstract: The authors' experiments have demonstrated a significant risk of systemic fat mobilization and fat embolism after liposuction in the animal model. Further clinical investigation is required to evaluate the real clinical risk of this procedure from this perspective.

Cited by 42 publications

References 20 publications

Fat embolism in liposuction and intramuscular grafts in rabbits

Fat embolism in liposuction and intramuscular grafts in rabbits

Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia

Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler Injections

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