Understanding Fatal Fat Embolism in Gluteal Lipoinjection: Analysis of 16 Autopsies Under the Loupe

Background: Deaths secondary to gluteal lipoinjection are relatively recent events of major importance. However, little is known in relation to their behavior and clinical evolution. Therefore, an analysis was performed of case records from clinical cases that encountered this problem, correlating the results with the findings during autopsies. Material and methods: An analysis was performed of records from patients who died secondary to gluteal lipoinjection. Patient-specific data, surgical procedure, clinical picture, evolution and outcome were analyzed. The findings of the autopsies and the involvement of other organs were also analyzed and correlated. Results: From 2000 to 2009, 16 files were obtained that fulfilled the indicated requirements. There were no statistically significant differences in the general characteristics of the patients, such as age, BMI or lipoinjected or liposuction volume. The clinical pictures were similar in all cases, and the autopsy findings showed the presence of microembolism in all cases and macroembolism in the most severe cases. CONCLUSIONS: The most significant parameter of severity in patients who undergo gluteal lipoinjection is the presence of fat in macroscopic form in the circulation. The volumes of liposuctioned or lipoinjected fat have little influence. Hypoxemia, hypotension and bradycardia are the characteristic clinical features. Although there is no specific treatment, immediate aggressive vital support to attempt to stabilize the patient is crucial. Financial disclosure and products: The authors have no conflict of interest to declare in relation to the content of this article Corresponding Author, Contact Information: Lázaro Cárdenas-Camarena MD, INNOVARE Cirugía Plástica Especializada, Av Verona 7412. Col Villa Verona, Zapopan, Jalisco, México 45019, drlazaro@drlazarocardenas.com ©2018American Society of Plastic Surgeons

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