I have picked a doc to do my bbl. He is an experienced (20 +years), American Board certified PS. He says that he injects some of the fat into the muscle for higher survival %. However Ive read that injecting into the muscle increases chances of fat embolism. He has assured me that he does 2 to 3/ week for the past 15 +years and injects as he's withdrawing the blunt cannula to prevent this. Am I being paranoid or should I request that he only inject into the fat..and if so, will it take?
January 4, 2017
Answer: Fat transfer and the risk of fat embolus Fat embolus is a very serious and known complication of fat transfer. 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.As always, discuss your concerns with a board certified plastic surgeon.
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January 4, 2017
Answer: Fat transfer and the risk of fat embolus Fat embolus is a very serious and known complication of fat transfer. 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.As always, discuss your concerns with a board certified plastic surgeon.
Helpful
January 6, 2017
Answer: Fat transfer to buttocks I personally stay above the muscle to lessen chances of a fat embolism. Many plastic surgeons do indeed inject into the muscle. Yes, a percentage of fat injected into the fat layer will survive the transfer.
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January 6, 2017
Answer: Fat transfer to buttocks I personally stay above the muscle to lessen chances of a fat embolism. Many plastic surgeons do indeed inject into the muscle. Yes, a percentage of fat injected into the fat layer will survive the transfer.
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