Pulmonary Fat Embolism Following Liposuction and Fat Grafting: A Review of Published Cases

• Published in: Healthcare (Basel) Vol. 11; no. 10; p. 1391
• Main Authors: Kao, Yu-Ming, Chen, Kuo-Tai, Lee, Kuo-Chang, Hsu, Chien-Chin, Chien, Yeh-Cheng
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 11.05.2023; MDPI
• Subjects: Acute respiratory distress syndrome; Autopsies; Body fat; Care and treatment; complication; Cosmetic surgery; Diagnosis; Edema; Embolism; fat embolism; fat grafting; Hospitalization; Hospitals; Hypotension; Hypoxia; Laboratories; Lavage; Liposuction; Medical personnel; outcome; Patient outcomes; Patients; Pneumonia; Pulmonary arteries; Pulmonary embolisms; Respiratory distress syndrome; Review; Thromboembolism; Taiwan; United States > US; cosmetic surgery; fat grafting; complication; liposuction; outcome; fat embolism
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare11101391

One of the most severe complications of liposuction and fat grafting is pulmonary fat embolism (PFE). However, most healthcare workers are not familiar with PFE. We performed a systematic review to describe the details of PFE. PubMed, EMBASE, and Google Scholar were searched up to October 2022. Further analysis focused on clinical, diagnostic, and outcome parameters. A total of 40 patients from 19 countries were included. Chest computed tomography (CT) yielded 100% accuracy in the diagnosis of PFE. More than 90% of the deceased died within 5 days after surgery, and in 69% of patients, onset of symptoms occurred within 24 h after surgery. The proportions of patients who required mechanical ventilation, had a cardiac arrest event, or died among all patients and among those whose onset of symptoms occurred within 24 h after surgery were 76%, 38%, and 34% versus 86%, 56%, and 54%, respectively. The earlier the onset of symptoms was, the more severe the clinical course was. Once a patient presents with PFE-related symptoms, surgery should be halted, supportive care initiated, and chest CT used to diagnose PFE. According to our review results, if a patient with PFE survives the initial episode without permanent sequelae, a complete recovery can be anticipated.