Embolism while having facial fat grafting done? Are there ways to avoid it?

Hi. I just read a news that a woman lost her vision while she was having fat transfer done to her temples. Where are the most dangerous areas for undergoing facial fat grating? And are there ways to avoid embolism? Thank you!

Doctor Answers 3

Fat Embolism And Fat Grafting

this is very rare and yes it is a risk that is avoided best with using properly harvested fat, slow injection technique and cannulas.  Avoiding too much around the eye area.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Embolism with facial fat transfer

Embolisms come in different forms. With fat transfer the most feared type of embolism is a fat embolism. This usually does not cause problems like blindness but rather problems with the lungs since that is usually where the embolus and stop. The difference depends on if the embolus is in an artery or a vein. And artery can cause tissue necrosis. The loss of an eyeball would be exceedingly rare from fat transfer since the retinal artery or the main artery that supplies the eyeball is in the very back of the eyeball it would be difficult to reach with fat transfer. The most common reason for blindness with surgical procedures around the eye are bleeding around the eye causing pressure on the eyeball for direct injury to the eyeball itself. Both of these should be exceedingly rare with facial fat transfer. The best way to prevent these is to be in the hands of someone who is talented. Simple technical expertise, good medical judgment, and understanding of facial anatomy and experience are the hallmarks of consistently high patient satisfaction with the least number of complications. Still complications can happen with any procedure in the hands of any provider. There's a saying in surgery but the only surgeons who don't have complications are the ones who don't operate. This may seem like a somewhat frightening and cynical statement. While true to some degree complications should always be looked in context to risk and probabilities. Facial fat transfer is generally a very safe procedure. By far the most common complication is bad aesthetic outcomes. Best, Mats Hagstrom M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 18 reviews

Rare but tragic

Fat embolism is a well described complication of fat transfer to the face. It is rare but can result in the death of small areas of skin and fat in the face (necrosis) or even worse, blindness if the eye vessels become occluded. There are several techniques to minimise its possibility. Adequate anesthetic infusion followed by fat injection through a cannula rather than a hollow needle. Injecting the fat as the needle is withdrawn also helps to minimise the chance of a vessel being pranged and then injected into. All of these are technical tips for the surgeon. I am not sure there is anything you can do as the patient to minimise the chances. Just be aware it is very very rare. Hope that helps.Adam Goodwin

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