Does having Smart Lipo Triplex done carry a risk of fat embolism?

Question

I'm curious if Smartlipo Triplex carries the same risks for PE that traditional lipo has? Thank you!

Jason Emer, MD · Answer

There is a low risk of fat embolism with Smart Lipo. For best results with treatments like Smart Lipo, I recommend adding a combination of radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing in order to get the best results. In our office we do a "Fire and Ice" treatment with Coolsculpting and Vanquish and get great outcomes. However, for the best results with contouring and fat removal, I recommend VASER HI DEF, with ThermiRF and ultrasound. See an expert for a formal consultation. Best, Dr. Emer

Marwan R. Khalifeh, MD · Answer

smartlipo itself should not reduce the risk of PE as compared to traditional lipo.  Your choice of anesthesia as well as an assessment of your personal history, medication list, and family history as well as smoking history are most relevant in assessing your risk of a PE.

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, yes it has the same risk as regular liposuction. One way to reduce the risk is to have the surgery under sedation vs general anesthesia, in that way you never go fully to sleep and that can mitigate risk!

Donovan Rosas, MD · Answer

Fat embolus is a very serious and known complication of fat transfer. The probability of embolus is much higher in the setting of fat transfer than for liposuction alone. While fat embolus, has always been known to be a potential complication of liposuction, the recent rise in high profile incidents is due in part to the meteoric rise of the BBL or buttock augmentation via fat transfer.
A fat embolus occurs when injected fat is inadvertently introduced into a vessel and travels centrally within the vasculature. The hallmark triad of symptoms include neurologic changes, a petechial rash, and respiratory changes. The treatment is typically supportive in nature. While it is a very serious complication, if diagnosed early it can be managed. Mortality rates are quoted as low as 5%.
While it is true, injection of donor fat into the infra-muscular plane (within the muscle) increases fat viability this does come with a significant increase in risk. There are large vessels deep to and within the muscle which can be inadvertently injected while grafting leading to a fat embolus. The consequences of such a complication are very serious and life threatening.
At the recent American Society of Plastic Surgeons Hot Topics, data from AAAASF (ambulatory surgical certifying body) was presented, suggesting that BBL /gluteal lipoaugmentation demonstrates a dramatically higher risk profile than other surgeries. The Aesthetic Surgery and Educational and Research Fund is convening a task force as well. The hope is that we will have more concrete guidelines for addressing these very serious complications.
That being said, the safest way to avoid fat emboli is to stay in the subcutaneous plane (at the expense of fat viability)and avoid the deeper muscular plane. If grafting of the deep plane is planned, surgeons should consider blunt cannulas, aspiration prior to injection. Using a supra-gluteal approach to minimize the risk of inadvertent intravascular injection has also been proposed.
Unfortunately, even when undertaking the maximal precautions, complications can occur.  They can occur to any physician irrespective of training, location etc. Thus it is very important to be followed closely by your physician. This will ensure that in the unlikely event of a problem, diagnosis can be made promptly and treatment started immediately. With regards to your specific question, SmartLipo is no more or less likely to result in fat emboli than traditional liposuction. However, the risks are much smaller than when combined with fat transfer. Additionally, SmartLipo is not typically employed for BBL as the laser destroys the fat which does not produce viable graft.
As always, discuss your concerns with a board certified plastic surgeon (ABPS)

Edgardo Zavala, MD · Answer

When a surgical procedure is performed, including Smart Lipo, there are always certain risks, like everything in life. The risks are related to the health of the patient, the type of procedure and the skills of surgeons, nurses and other surgical assistants. Well performed, under good tumescent anesthesia and at the most mild conscious sedation this procedure is extremely safe. The risk of fat embolism is extraordinarily low. I have performed well over 5000 cases never seeing such a complications. Make sure your surgeon is experienced and you should be fine. Good luck

Michael H. Gold, MD · Answer

Thanks for your question and all liposuction procedures carry the same risks, no matter how it is done.  What decreases the risks is the type of anesthesia is done – performed under tumescent anesthesia has shown to be the safest and best way to perform laser liposuction – and this can be done in a proper office setting by a skilled surgeon.  See a board certified dermatologist or plastic surgeon who does this to assure the best situation for you.

Reza Tirgari, MD · Answer

All liposuction carries the same (very small) risk of fat embolism.  It is fat transfer that incurs the highest risk.
However, many of these different forms of lipo, and different machines that are used are mostly gimmicks.  Do not let any surgeon "sell" you on the machine/laser/etc.  Indeed, most of the best surgeons won't do this.  The ultimate factor that determines the quality of your result - and the safety of the procedure - is going to be the skill and experience of the surgeon.  This should be your first priority.
Your best bet:
1- Ask how many lipo procedures the surgeon has done.
2- Ask for a series of before/after photos
3- Ask whether he/she has had any complications and how these were managed
4- Ask to speak to other patients (if possible).
5- Ask what percentage of the surgeon's practice is lipo.  If it is 80% vs. 5% that should tell you something.
Hope that helps.

Ven Erella, MD · Answer

Thank you for your question. Smart lipo with triplex will not rise fat embolism itself. It there with any lipo but not common. Risk with fat transfer is much higher for fat embolism

David E. Berman, MD (retired) · Answer

i have done almost 700 cases in my office with Smartlipo under local anesthetic (usually with oral sedation but no IV sedation) so there is no need to have a general anesthetic. This makes your risk of a DVT extremely low. A fat embolus is extremely rare compared to a blood clot embolus and wold be very rare with liposuction.david berman md

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