Autogenous Fat Grafting to the Breast and Gluteal Regions: Safety Profile Including Risks and Complications

Abstract

Summary: Given the widespread utility and therapeutic potential of autogenous fat grafting, plastic surgeons should be familiar with its safety profile and associated adverse events. This article provides a critical review of the literature and delineates risk factors associated with various complications when grafting to the breast and gluteal regions. The majority of adverse events are related to fat necrosis and require minimal diagnostic or therapeutic intervention. Larger graft volumes, as in cosmetic augmentation, are associated with higher incidences of fatty necrosis. The oncologic safety of fat grafting is supported by multiple clinical studies with thousands of breast cancer patients, albeit predominantly retrospective in nature. Although less frequent, serious complications include fat emboli during gluteal augmentation. Identification of associated risk factors and implementation of proper surgical techniques may minimize the occurrence of life-threatening complications.

Adipose Tissue Transfer in Dynamic Definition Liposculpture Part II. The Lower Limb: Gastrocnemius, Vastus Medialis, Vastus Lateralis, and Rectus Femoris Muscles

“…24,25 In addition, the newest recommendations for gluteal adipose grafting (after the 2018 practice advisory from the Multi-Society Task Force for Safety in Gluteal Fat Grafting) include the use of ultrasound-guided documentation of cannula placement before and during fat injection and the limitation of three BBL cases as a maximum amount of total operative cases per day. 26 To our knowledge, there has not been any fatality or pulmonary fat embolism reported in the medical literature after IM fat grafting in a muscle other than the gluteus major, 27–31 or any case report of ACS following aesthetic procedures of the lower limb. 32–34 Animal studies have shown that IM fat grafts have no association with long-/short-term events of fat embolism after autologous fat transplantation, which further supports the special case of the gluteus major muscle.…”

Adipose Tissue Transfer in Dynamic Definition Liposculpture PART III. The Arms: Biceps, Triceps, and Deltoids

“…19 Likewise, other authors such as Cancansao et al and Pazmiño et al have reported the advantages of US in the safety profile of aesthetic lipoinjection. 20,21 Even though fat grafting is actually part of the HD2 technique itself, we described both procedures separately with the sole purpose to emphasize the importance of a safety practice of IM fat grafting. In any case, the surgeon must be aware of any unexpected trauma to the arm that could result in acute compartment syndrome or fat embolism, both considered severe and devastating complications.…”

“…19 Likewise, other authors such as Cancansao et al and Pazmiño et al have reported the advantages of US in the safety profile of aesthetic lipoinjection. 20,21…”

Fat grafts enriched with ex‐vivo expanded adipose stem cells improve hyperpigmentation of face

“…Researchers have tried many ways to ensure the survival of injected fat at recipient site. Donor area preparation, changes in tumescence fluid composition and volume, fat washing, filtration method, volume of fat injected at recipient site, preinjection expansion of recipient area, addition of PRP, and use of anti‐inflammatory agents are among various techniques so far applied to serve the purpose (Chopan et al, 2019; Gentile et al, 2019). Similarly, deferoxamine and beta‐1‐blocker metoprolol preconditioning resulted in improved perfusion and fat graft retention.…”