Autologous fat grafting has gained great popularity in aesthetic and reconstructive surgery. However, recent reports of severe complications after fat grafting are increasing, especially fat embolism. It should be paid much attention to the surgical processes as the treatment is extremely difficult. Here, we analyzed the vascular embolism associated complications after fat grafting, and summarized the risk factors as well as preventive measures.

Autologous fat grafting has gained great popularity in aesthetic and reconstructive surgery. However, recent reports of severe complications after fat grafting are increasing, especially fat embolism. It should be paid much attention to the surgical processes as the treatment is extremely difficult. Here, we analyzed the vascular embolism associated complications after fat grafting, and summarized the risk factors as well as preventive measures.

Objective:To explore whether botulinum toxin A (BTX-A) can improve the retention rate of fat transplantation in fat breast augmentation.Methods:Each patient was divided into control side and experimental side according to the random number table in 14 patients studied. The experimental group received autologous fat and BTX-A combined transplantation on both sides of the breast, while the control side only received autologous fat transplantation. The fat was added with the same volume of normal saline as BTX-A in the control group. All patients were followed up and the effects of BTX-A were evaluated objectively via the comparison of the remained bilateral fat graft volumes that were obtained through a digital three-dimensional reconstructions technique. Moreover, the improvement of each breast appearance and complication were assessed by the physician and patients who were blinded to the recipient treatment assignment.Results:The outcome of the fat breast augmentation was evident for both groups at the follow-up with no evidence of fat embolism, vascular/nervous injury, infection and prolonged bruising. In one of the 14 patients (control group), fat liquefaction necrosis occurred in one side of the breast; after active treatment, it returned to normal, and three patients had different degrees of mass. The analysis on the three-dimensional reconstruction data and the assessments from both the physicians and patients showed significant differences in the fat graft retention volume between the BTX-A group (51.10±20.56)% and the control group (33.06±14.77)%. Nevertheless, there was no significant difference in the incidence of complications between the two sides.Conclusions:Autogenous fat breast augmentation is safe and effective. This study result has shown that BTX-A can significantly improve the retention rate of fat transplantation but cannot reduce the incidence of complications.