Sepsis With Multiple Abscesses After Massive Autologous Fat Grafting for Augmentation Mammoplasty: A Case Report

Abstract

Background Autologous fat grafting to the breast for breast reconstruction and cosmetic breast augmentation has gained much attention recently. However, its efficacy and the severities of its associated complications are of concern. The authors experienced one case of multiple breast abscesses after augmentation mammoplasty by autologous fat grafting. Methods A 42-year-old woman presented to the authors' emergency department reporting tenderness, swelling, and a sensation of heat in both breasts. The patient had undergone augmentation mammoplasty by autologous fat grafting 7 days previously. Abscess formation was suspected based on the patient's history, physical examination, laboratory findings, and image study. Results Incision and drainage were performed immediately with the patient under general anesthesia, and 500 ml of a foul, brown, turbid, purulent fluid containing necrotic fat debris was drained from each breast. Empiric antibiotics were started on the first hospital day, and betadine and saline-irrigation were administered daily for 2 weeks. Incisions were closed on hospital day 19 when laboratory data and local infection signs had improved. At the patient's 9-month follow-up assessment, breast contours were found to be well preserved, and scarring was minimal. Conclusion Immediate complications such as edema, hematoma, and infection require serious consideration after autologous fat grafting in the breast. In particular, infection probably is the most serious complication because the volume of the fat injected is large and can induce systemic infections such as sepsis and distort the contours of the breast. To avoid such infections, systemic and multicenter studies are required to determine how fat grafting should be performed to minimize the risks of fat necrosis and infection.

Comparative technical analysis of lipoaspirate mechanical processing devices

“…In one work (Brzezienski & Jarrell, 2016), surgeons indifferently used the GID700 and Puregraft devices, and no comparison of clinical results is made. The identified clinical results refer to multiple fields of application: 14 papers refer to breast reconstruction (Brzezienski & Jarrell, 2016;Chiu, Fracol, Feld, Qiu, & Kim, 2019;De Fazio & Cingozoglu, 2020;Economides & Song, 2018;Gabriel et al, 2017;Lee et al, 2011;Losken et al, 2011;Mestak et al, 2014;Mestak, Mestak, Bohac, Edriss, & Sukop, 2013;Mestak & Zimovjanová, 2012;Ruan et al, 2019;Russe et al, 2015;Sforza, Andjelkov, Zaccheddu, Husein, & Atkinson, 2016;Wang et al, 2012), 5 to osteoarthritis (4 of the knee and 1 of the hip) (Barfod & Blønd, 2019;Dall'Oca et al, 2019;Jones et al, 2018;Panchal, Malanga, & Sheinkop, 2018;Schiavone Panni et al, 2019), 3 to complex anal fistula (Laureti et al, 2020;Naldini, Sturiale, Fabiani, Giani, & Menconi, 2018;Topal, Eray, Rencüzo gulları, Yalav, & Alabaz, 2019), whereas 8 studies concern different pathologies (Casarotti, Chiodera, & Tremolada, 2018;Cestaro, De Rosa, Massa, Amato, & Gentile, 2015;Cherian, Malanga, Hogaboom, Pollack, & Dyson-Hudson, 2019;Hirahara, Andersen, & Panero, 2017;Kuka et al, 2020;Lonardi et al, 2019;Saibene, Pipolo, Lorusso, Portaleone, & Felisati, 2015;Zuin et al, 2019). The interesting fact is that all the aforementioned devices are mainly used for breast reconstructions, exc...…”

Treatment of an abscess after massive autologous fat transplantation for breast augmentation with real-time ultrasonography-guided liposuction

“…The remaining abscess and necrotic fat were also localized and removed using liposuction equipment with real-time US guidance in the operating room, preserving the normal adipose tissue as much as possible and maintaining the contour of the breast. Unlike invasive incision and drainage, which were reported in previous cases, the use of liposuction through a minimal incision allowed us to minimize the visible scar [6,14]. The incision on the right breast was made by extending the fistula in the lower pole by 1 cm, and the left breast was incised by 1.5 cm at the axilla to hide the scar as close as possible to the abscess pocket that was located using US.…”

Breast reconstruction de novo by water-jet assisted autologous fat grafting – a retrospective study

“…In five cases autologous fat grafting was used as a salvage method after failure of implant reconstruction. In contrast to other large volume fat grafting techniques, our complication rates per procedure for liponecrotic pseudocysts formation (2.96%), infection (0.74%) or granuloma (0.74%) are very low [7], [26], [32], [34], [66]. Fat necrosis within the breast mainly occurs as common phenomenon after trauma, biopsy, implant removal, flap reconstruction, lipotransfer or radiation [16], [18], [41], [44], [60], [63].…”