Is there a way surgeons can prevent fat embolism from lipo?

Question

I read that fat embolism can occur from liposuction alone. Can surgeons prevent this or can it just happen? Very scared of death from this

Daniel Barrett, MD · Answer

Dear Dunkindo,

as long as the surgeon follows all the recommendations and stays above the muscle, then the risk of embolism is low. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!Although fat embolism is a possibility with liposuction , it is extremely rare if the liposuction was done right. Fat embolism is more common during fat grafting procedures especially when done to muscles (usually large ones ) with big vessels and under pressure . So if your surgeon uses sate techniques to perform your liposuction and remains in the right plane you should be safe.I hope this helps! best of luck!

James Knoetgen, III, MD · Answer

Your fear is totally valid – fat embolism is a serious but rare complication of liposuction. Let’s break it down so it’s less scary and more understandable. 
What is Fat Embolism?
Fat embolism occurs when fat enters the bloodstream and travels to the lungs, heart, or brain. It can lead to a fat embolism syndrome (FES), which can be life-threatening if severe. 
While it’s more commonly associated with large orthopedic trauma (like long bone fractures), it can happen during liposuction or fat transfer procedures, especially if fat is injected into or near large veins. 
Can It Happen from Liposuction Alone? 
Yes, but it’s extremely rare. It’s more common in Brazilian Butt Lift (BBL) procedures where fat is injected into the gluteal muscles and potentially near large veins. 
In traditional liposuction (removing fat), fat embolism is less likely, but not impossible – especially if: 
•	Very large volumes of fat are removed
•	The procedure is aggressive or rushed 
•	The surgeon uses poor technique
How Do Surgeons Prevent It?
Good surgeons take multiple steps to reduce the risk: 
1.	Proper Technique: Avoid deep injections and stay in the subcutaneous (above the muscle) fat layer. 
2.	Cannula Control: Using blunt-tip cannulas and careful insertion angles reduces the risk of piercing veins. 
3.	Volume Limitation: Staying within safe fat removal limits (usually

Camille Cash, MD · Answer

Safety is the priority in surgery.  Every surgery carries a certain amount of risk but there is much that can be done to keep this risk to a minimum.  When you meet with your surgeon a review of your medical history will be performed and potential risks will be identified.  There are several things that you can do both pre and post op to keep your risk minimized.  Closely follow the surgeons instructions regarding any medications or supplements you take.  Eat a healthy, balanced diet and get regular exercise.  After surgery be sure to take take deep breaths regularly and walk around a little each day according to your surgeons instructions.

Connie Hiers, MD, FACS · Answer

Fat embolism is very rare with just liposuction because suction is being applied at all times when the cannula or tube is inserted, and it sucks fat out instead of pushing it inside. Embolism is more common with lengthy procedures, especially over 4 hours, and general anesthesia. You might consider awake liposuction done under local anesthesia. It carries the lowest risk.  Also, under general anesthesia, cafe massage is often done to decrease blood clots from your leg veins.

Mats Hagstrom, MD (license on probation) · Answer

Risk typically has two components.
One is the implication and the other is the rate.
While it is possible to have a fat embolism from Liposuction, it is highly highly unlikely.
It’s probably more likely you’ll have a fat embolism from being in a car accident with a broken femur.
 I don’t know the incidents and I don’t think anyone does.
My best guess is that fat embolism from Liposuction alone is less than one in 100,000.
When people start worrying about surgical complications, they tend to see it as all or none.
Without putting the incidents into context, the risk seem overwhelming.
 The chance of dying from Liposuction is not going to be from a fat embolism, but an intro abdominal injury.
Most fatality is from Liposuction, From in abdominal injuries, perforating the colon with delayed diagnosis.
Other intra-abdominal or intrathoracic structures can be damaged like the lung heart and major blood vessels.
Infections, including necrotizing fasciitis are also probably more common as a cause of major complications than fat embolism.
Again, I don’t know the incident but my best guess is that fat embolism is fairly low on the list in regards to what causes fatalities from Liposuction.
Liposuction in the hands of a highly experienced Plastic surgeon who does liposuction on a regular basis is very safe.
For reference, let’s take a look at other serious risks that most people are willing to accept in life.
I typically use driving as a good reference point.
The fatality of an average driver driving for one year is one in 10,000.
That means an average person who drives on a regular basis has a one and 1000 chance of dying from driving over a decade.
Most people don’t think twice about getting in a car even though it is one of the more dangerous things we engage in.
 My best guess is that the fatality for Liposuction is probably around one and 50,000.
If that’s accurate, then it would be the equivalent of driving a car for five years.
Nobody has to have cosmetic surgery.
If you’re worried about complications, then maybe the first thing to do is to confirm if you’re a good candidate for the procedure in the first place.
Not everybody seeking Liposuction is a candidate for this procedure.
Rarely are people perfect or non-candidates.
Candidacy is typically more of a spectrum.
 On average if I see 10 patients for Liposuction consultations, typically two patients will be non-candidates, two patients will be perfect candidates and six patients will be somewhere in between.
If you’re not an ideal candidate or not even a good candidate then maybe it doesn’t make any sense to take a risk if the outcome isn’t going to be all that great.
 Generally speaking an ideal candidate for Liposuction is someone who is young, pudgy and has tight skin.
The opposite is also true. older people with skin laxity and thin layers of subcutaneous fat typically are not good candidates for liposuction.
There are two variables that determine Liposuction outcomes.
The first patient candidacy and the second is provider selection.
The number of plastic surgeons who deliver consistent exceptional Liposuction outcomes is in fact quite small.
Almost all plastic surgeons will claim competency with Liposuction, but that is quite different and having the ability to deliver consistent quality outcomes.
Before worrying about risk, I suggest you consider getting an assessment and start working on provider selection.
In the process you’ll get well informed.
Sitting in front of your computer or cell phone reading about risk probably isn’t helping you.
Best,
Mats Hagstrom MD

Is there a way surgeons can prevent fat embolism from lipo?

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