Fat embolism/thrombosis risks due to lipo to flanks & belly then fat injection to the breasts?

Question

What are the risks of a fat embolism and thrombosis due to lipo to flanks and belly and then fat injection to the breasts? Can lipo and fat injection to the above mentioned areas cause a fat embolism / thrombosis?

Alan Gonzalez, MD, FACS · Answer

Hello @ibac, thank you for your question. The important thing is not to skip any steps in order to avoid complications.  Liposuction and fat transfer procedures do carry a risk like any other procedures. However, in the hands of experienced, board-certified plastic surgeons, and with the right precautions, these risks are really low. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs.  Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

John L. Burns Jr., MD · Answer

A fat embolism occurs when fat is placed into a blood vessel by mistake and it travels to the lungs.  This occurs more frequently in BBL if fat is placed into the gluteus muscle.  Placing fat above the gluteus has virtually eradicated this complication.  Breast fat transfer is done by placing fat into the breast tissue.  The blood vessels are very small making fat embolism extremely rare in the breast.  A DVT or blood clot is a different issue which relates to blood clots forming in the large pelvic and leg veins that can travel to the lungs.   DVT is more common with procedures like liposuction and tummy tucks.  DVT prophylaxis should be used:  sequential compression devices during surgery, early ambulation, minimizing blood loss in surgery, limiting surgical time, and anticoagulant therapy are all way to prevent DVT.

Daniel Barrett, MD · Answer

Dear ibac,
every surgery has a risk of thrombosis and embolism. However, with proper preoperative, postoperative protocols and surgical techniques, the risk is very 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The risks are very low. Liposuction by itself rarely causes thrombosis unless the procedure is very long, longer than 4 hours, and under general anesthesia.  Even so, the blood clots are long the long veins in the legs. The fat transfer to the breasts that naturally contain fat is also very low since the injecting canulae are small and medication is injected to constrict blood vessels and reduce bleeding. There is a much higher risk in injecting fat into buttocks, especially if the fat is placed inside muscles which have larger blood vessels and where constricting medication is not placed.

Mats Hagstrom, MD (license on probation) · Answer

To my knowledge, no one has calculated the risk of fat embolism from breast fat transfer.
I’ve never heard of a single case, but that does not mean a complication isn’t possible. My opinion, the biggest risk patients should be worried about before considering this procedure is not understanding their candidacy for the procedure, what the procedure can, or cannot accomplish, and not focusing enough efforts on finding the best provider.
In regards to serious risk, the risk of being left permanently disfigured by far higher and more real, than theoretical complications that have not yet been described.
All surgery has risk involved, and Liposuction and fat transfer is no exception. Individuals for a highly risk averse should consider not having a necessary elective cosmetic surgery procedures.
All patients have the ability to decrease undesirable outcomes by choosing sufficiently skilled and experienced providers.
Do that I have a multiple of in person, consultations with local, board-certified plastic surgeons, who seem to have experience with the procedure. Ask each provider to open up their entire portfolio of before and after pictures of previous patients who have similar body characteristics to your own. 
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Continue having consultations until you feel confident you found a surgeon with sufficient skill and experience to deliver consistent quality results that meet your needs.When, in doubt, slow down and schedule more consultations.
Breast fat transfer can increase breast size by 1/2 cup or approximately 50% total volume increase. Procedure does, however not change breast shaped in any significant meaningful way. The procedure is good for women who are content with the overall shape and contour of their breast, including nipple position, but just want them to be slightly larger. The result of breast fat transfer is subtle compared to other Aesthetic surgery options, like implant, augmentations, or a mastopexy. Women who want a significant change in shape of their breast, like volume in the upper half of the breast, breast projection, or treatment for breast ptosis should consider more appropriate procedures.
Best,
Mats Hagstrom, MD

Fat embolism/thrombosis risks due to lipo to flanks & belly then fat injection to the breasts?

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