Can one have a fat embolism while in BBL recovery? Like not during surgery. What is the probability?

Thank you for your question. This is a very important and timely question you posted. Since Brazilian Butt Lifts are climbing in popularity, so do the adverse events including death. Out of  200,000 BBLs, 32 fatal pulmonary fat emboli and 103 non-fatal fat emboli were reported.This is a very rare occurrence and it shows again why it is important to chose a board certified plastic surgeon with experience in this type of surgery. These events almost always present intraoperatively or shortly thereafter. All of them were technique related by surgeons injecting deep into the gluteal muscle (were the major arteries, veins and nerves are) and causing a tear in the vessel, injecting at high pressure gradient, pointing the injection cannula downwards and using a small injection cannula.It is important for the surgeon to know the pelvic anatomy well, use the appropriate technique, have the patient positioned correctly on the operating room table and use a cannula that is 4mm in diameter and not smaller.

Thanks for your question. Getting a Fat emboli is always a possibility after surgery but extremely unlikely as it most of the time occurs during surgery.  The reason people have fat emboli is due to trauma in blood vessels were fat can get sucked in and then go into your circulation. Sometimes the fat gets directly injected into an artery or vein which then goes into your circulation. The reason this causes a problem is because the clot can be so large that it stops the blood flow. There are certain measures that most certified Plastic Surgeon can take to avoid getting fat emboli such as not injecting below the muscle, using cannulas that are not sharp or dissecting, not injecting with too much force and the answer that I think is more so  is experience.  The risk is really small in the range of less than one per over 5000 to 15,000 depending on the study that you look at.   I hope this information does not discourage you from having a Brazilian butt lift just make sure to check out who you are board-certified plastic surgeon is and ask them if they have ever had anybody had a fat emboli. most surgeons who have done enough procedures will eventually have one in their career. All the best,  Carlos Mata MD Board-certified plastic surgeon

This is a hot topic in plastic surgery right now. Recently published data looking at the incidence of fat emboli in BBLs place the incidence at approximately 1 in 6500. These numbers are based on an international survey sent to plastic surgeons  throughout the world. The relative experience of the surgeons performing the procedure who filled out the survey was not reported. 
Things the surgeon can do to minimize risk include using large cannulas to inject (>4.1 mm), low pressure injection, and avoidance of a deep plane of injection. 
Things you can do is make sure you seek out a board certified plastic surgeon who performs a large number of BBL procedures. Knowledge of buttock and pelvic anatomy is key to performing the operation safely. Although it sounds surprising, fat emboli are usually the result of injections deeper than intended or in anatomical planes that are rich in blood vessels. 
Hope this helps! Sam Jejurikar, MD

Generally speaking fat embolus occurs at the time of procedure when a vessel is inadvertently cannulated and fat injected into the intravascular space. However, the symptoms (respiratory distress, neurologic changes and petechial rash) may not manifest immediately.This is a known complication of the procedure but can be avoided by avoidance of the submuscular plane, aspiration before injection and the use of large bore blunt cannulas. Once an embolus occurs, treatment is supportive but early diagnosis is crucial for good outcomes.As always, discuss your concerns with a board certified plastic surgeon (ABPS). 

It is possible to get an embolism during recovery depending upon the techniques used.  Fat injection through large bore blunt cannula above the muscle makes it virtually impossible to get a fat embolus, but the risk for fat necrosis and infection is likely higher due to reduced vascularity of that area.