Fat Embolism following Liposuction

Abstract

The action of liposuction with vacuum and movement of the cannula back and forth results in fragments of fat globules, torn fat cells, and neutral fat. During liposuction, blood vessels are disrupted, leaving a path for the fatty acids to enter the vascular system. The pulmonary vascular occlusion in fat embolism is often temporary or incomplete since fat globules do not completely obstruct capillary blood flow because of their fluidity and deformability. The initial symptoms of fat embolization are probably caused by mechanical occlusion of multiple blood vessels with fat globules that are too large to pass through the capillaries. The neutral fat that embolizes to the pulmonary circulation can be degraded by pneumocytes to free fatty acids that are injurious to the pulmonary parenchyma, leading to adult respiratory distress syndrome. The fat embolism syndrome is characterized by acute hypoxemia, respiratory distress, central nervous system dysfunction, and a petechial rash involving the head, neck, anterior thorax, or axilla. The diagnosis of pulmonary fat embolus is largely based on typical symptoms and signs. Treatment consists mainly of supportive measures.

Fat Embolism and Severe Natural Disease: Challenges for Certification

“…Although a clinical diagnosis of fat embolism was not entertained, our patient's respiratory failure clearly worsened after the fracture, and respiratory symptoms with coughing during repositioning strongly suggest additional showers of embolic fat. Shiffman and Costa et al also reported dry cough in patients who suffered from fat embolism after liposuction (8, 9). Although, timely stabilization of fractures has been suggested to minimize the risk of fat embolization, this was not feasible in our patient due to her severe heart disease (10).…”

Current trends of liposuction in India: Survey and Analysis

“…It has been repeatedly shown in animal studies[ 34 35 36 ] that there is a definite systemic mobilization of fat following liposuction. FES has been reported[ 37 38 39 40 ] but is difficult to diagnose. It is possible that the majority of these cases remain undiagnosed and hence, the true incidence is underreported.…”