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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(01): 14-22
DOI: 10.5999/aps.2017.01347
Original Article

Correlation between the time elapsed after liposuction and the risk of fat embolism: An animal model

Kwang-Ryeol Lim
Department of Plastic and Reconstructive Surgery, Dong-A University School of Medicine, Busan, Korea
,
Jeong-Min Cho
Department of Plastic and Reconstructive Surgery, Dong-A University School of Medicine, Busan, Korea
,
Chung-Min Yoon
Department of Plastic and Reconstructive Surgery, Dong-A University School of Medicine, Busan, Korea
,
Keun-Cheol Lee
Department of Plastic and Reconstructive Surgery, Dong-A University School of Medicine, Busan, Korea
,
Sang-Yun Lee
Ellium Women’s Hospital, Busan, Korea
,
Mi-Ha Ju
Department of Pathology, Dong-A University School of Medicine, Busan, Korea
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Background Liposuction has become one of the most frequently performed procedures in the field of aesthetic surgery. Fat embolism syndrome after liposuction can easily be overlooked or underestimated; however, occasionally, fulminating fat embolism syndrome can develop and lead to a critical situation within 2–3 days after lipoplasty. Changes over time in the amount of circulating fat particles and the histology of major organs have not yet been studied.

Methods This study was conducted using 18 male Sprague-Dawley rats aged 12 weeks and weighing 500–628 g (average, 562 g). Fifteen rats were used as the experimental group and 3 as the control group. Under general anesthesia, tumescent-technique liposuction was performed at the lateral flank areas and abdomen for 1 hour. Blood, lung, and brain tissue specimens were obtained at 1 hour, 1 day, and 2 days after the liposuction procedure.

Results The average number of fat particles in the blood samples was 25,960/dL at 1 hour, 111,100/dL at 24 hours, and 21,780/dL at 48 hours. The differences between study groups were statistically significant. Both intravascular and extravascular fat particles with inflammation were seen in all 15 rats, as were inflammatory cell infiltration, hemorrhage, and consolidation with shrinkage of the lung alveoli.

Conclusions These results imply that there is a strong possibility of fat embolism syndrome after liposuction in real clinical practice, and the first 24–48 hours after the operation were found to be the most important period for preventing pulmonary embolism and progression to fulminating fat embolism syndrome.

Keywords

Liposuction - Adipose tissue - Embolism - Fat embolism syndrome

This study was supported by research funds from Dong-A University.




Publication History

Received: 17 August 2017

Accepted: 18 October 2017

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Wang HD, Zheng JH, Deng CL. et al. Fat embolism syndromes following liposuction. Aesthetic Plast Surg 2008; 32: 731-6
    CrossrefPubMedGoogle Scholar
  • 2 Coleman 3rd WP, Hanke CW, Orentreich N. et al. A history of dermatologic surgery in the United States. Dermatol Surg 2000; 26: 5-11
    CrossrefPubMedGoogle Scholar
  • 3 Rohrich RJ. The increasing popularity of cosmetic surgery procedures: a look at statistics in plastic surgery. Plast Reconstr Surg 2000; 106: 1363-5
    CrossrefPubMedGoogle Scholar
  • 4 Glover P, Worthley LI. Fat embolism. Crit Care Resusc 1999; 1: 276-84
    PubMedGoogle Scholar
  • 5 Levy D. The fat embolism syndrome: a review. Clin Orthop Relat Res 1990; (261) 281-6
    PubMedGoogle Scholar
  • 6 Iverson RE, Lynch DJ. Practice advisory on liposuction. Plast Reconstr Surg 2004; 113: 1478-90
    CrossrefPubMedGoogle Scholar
  • 7 Liljedahl SO, Westermark L. Aetiology and treatment of fat embolism: report of five cases. Acta Anaesthesiol Scand 1967; 11: 177-94
    CrossrefPubMedGoogle Scholar
  • 8 Ross RM, Johnson GW. Fat embolism after liposuction. Chest 1988; 93: 1294-5
    CrossrefPubMedGoogle Scholar
  • 9 Illouz YG. Complications of liposuction. Clin Plast Surg 2006; 33: 129-63
    CrossrefPubMedGoogle Scholar
  • 10 Fourme T, Vieillard-Baron A, Loubieres Y. et al. Early fat embolism after liposuction. Anesthesiology 1998; 89: 782-4
    CrossrefPubMedGoogle Scholar
  • 11 Christman KD. Death following suction lipectomy and abdominoplasty. Plast Reconstr Surg 1986; 78: 428
    CrossrefPubMedGoogle Scholar
  • 12 Kiernan JA. Histological and histochemical methods: theory and practice. Oxford: Pergamon Press; 1981
  • 13 Kenkel JM, Brown SA, Love EJ. et al. Hemodynamics, electrolytes, and organ histology of larger-volume liposuction in a porcine model. Plast Reconstr Surg 2004; 113: 1391-9
    CrossrefPubMedGoogle Scholar
  • 14 Gurd AR. Fat embolism: an aid to diagnosis. J Bone Joint Surg Br 1970; 52: 732-7
    PubMedGoogle Scholar
  • 15 Shier MR, Wilson RF. Fat embolism syndrome: traumatic coagulopathy with respiratory distress. Surg Annu 1980; 12: 139-68
    PubMedGoogle Scholar
  • 16 Gossling HR, Donohue TA. The fat embolism syndrome. JAMA 1979; 241: 2740-2
    CrossrefPubMedGoogle Scholar
  • 17 Lequire VS, Shapiro JL, Lequire CB. et al. A study of the pathogenesis of fat embolism based on human necropsy material and animal experiments. Am J Pathol 1959; 35: 999-1015
    PubMedGoogle Scholar
  • 18 Pell AC, Hughes D, Keating J. et al. Brief report: fulminating fat embolism syndrome caused by paradoxical embolism through a patent foramen ovale. N Engl J Med 1993; 329: 926-9
    CrossrefPubMedGoogle Scholar
  • 19 El-Ali KM, Gourlay T. Assessment of the risk of systemic fat mobilization and fat embolism as a consequence of liposuction: ex vivo study. Plast Reconstr Surg 2006; 117: 2269-76
    CrossrefPubMedGoogle Scholar