Ophthalmic Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-Analysis

• Published in: Aesthetic plastic surgery Vol. 46; no. 6; pp. 3013 - 3035
• Main Authors: Mortada, Hatan, Seraj, Hadeel, Alhamoud, Mustafa A., Alghoribi, Reema Saleh, Alsuhaibani, Omar Saleh, Khoshhal, Mohammed Saad, Neel, Omar Fouda
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2022; Springer Nature B.V
• Subjects: Blindness - etiology; Case reports; Diplopia; Humans; Medicine; Medicine & Public Health; Meta-analysis; Ophthalmology; Otorhinolaryngology; Plastic Surgery; Prospective Studies; Retrospective Studies; Review; Systematic review; Veins & arteries; Vision loss; Ophthalmic complications; Ophthalmoplegia; Injections; Autologous fat; Aesthetic surgery
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-022-02924-5

Introduction With the recent increase in interest in using autologous fat (AF) filler injections to enhance aesthetic facial appearance, there is a noticeable increase in the complications such as vascular compromise and blindness. This systematic review and meta-analysis aimed to understand the symptomatology of ophthalmic complications related to AF facial injections for cosmetic purposes, their underlying causes, management options, and the final clinical outcomes. Methods This review was conducted according to the International Prospective Register of Systematic Reviews (PROSPERO) guidelines. In November 2021, we performed a systematic review of available literature using the following electronic databases: Cochrane, MEDLINE, and EMBASE. Our search was limited to the published studies between 2000 and 2021. Results A total of 1052 publications and 34 articles published were included. Twenty case reports, two case series, one prospective cohort study, and eleven retrospective studies were evaluated. The forehead was the most common single injection site ( n = 196, 55.36%). The most common initial symptom was periorbital swelling (92.7%). The pooled prevalence of ophthalmic artery occlusion was 50.4% out of all AF injection-related complications. Regarding the management, most patients were managed conservatively ( n = 278, 51.38%). Complete improvement was observed among 423 patients (80.57%). Conclusion Autologous facial fat injection is a minimally invasive procedure with a favorable safety profile in cosmetic applications. However, the common use of these injections in aesthetic surgery has resulted in a concomitant increase in devastating consequences, such as blindness. Therefore, a firm understanding of the potential complications of such interventions is essential. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .