Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force
- PMID: 28369293
- PMCID: PMC5846701
- DOI: 10.1093/asj/sjx004
Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force
Abstract
Background: Gluteal fat grafting is among the fastest growing aesthetic procedures in the United States and around the world. Given numerous anecdotal and published reports of fatal and nonfatal pulmonary fat embolism resulting from this procedure, the Aesthetic Surgery Education and Research Foundation (ASERF) formed a Task Force to study this complication.
Objectives: To determine the incidence of fatal and nonfatal pulmonary fat embolism associated with gluteal fat grafting and provide recommendations to decrease the risks of the procedure.
Methods: An anonymous web-based survey was sent to 4843 plastic surgeons worldwide. Additional data on morbidity and mortality was collected through confidential interviews with plastic surgeons and medical examiners, public records requests for autopsy reports in the United States, and through the American Association for the Accreditation of Ambulatory Surgical Facilities (AAAASF).
Results: Six hundred and ninety-two (692) surgeons responding to the survey reported 198,857 cases of gluteal fat grafting. Over their careers, surgeons reported 32 fatalities from pulmonary fat emboli as well as 103 nonfatal pulmonary fat emboli. Three percent (3%) of respondents experienced a patient fatality and 7% of respondents reported at least one pulmonary fat embolism in a patient over their careers. Surgeons reporting the practice of injecting into the deep muscle experienced a significantly increased incidence rate of fatal and nonfatal pulmonary fat emboli. Twenty-five fatalities were confirmed in the United States over the last 5 years through of autopsy reports and interviews with surgeons and medical examiners. Four deaths were reported from 2014 to 2015 from pulmonary fat emboli in AAAASF facilities.
Conclusions: Despite the growing popularity of gluteal fat grafting, significantly higher mortality rates appear to be associated with gluteal fat grafting than with any other aesthetic surgical procedure. Based on this survey, fat injections into the deep muscle, using cannulae smaller than 4 mm, and pointing the injection cannula downwards should be avoided. More research is necessary to increase the safety of this procedure.
© 2017 The American Society for Aesthetic Plastic Surgery, Inc.
Figures
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Comment in
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Commentary on: Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force.Aesthet Surg J. 2017 Jul 1;37(7):807-810. doi: 10.1093/asj/sjx080. Aesthet Surg J. 2017. PMID: 28486673 No abstract available.
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Commentary on: Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force.Aesthet Surg J. 2017 Jul 1;37(7):811-813. doi: 10.1093/asj/sjx075. Aesthet Surg J. 2017. PMID: 29025222 No abstract available.
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References
-
- The American Society for Aesthetic Plastic Surgery 2015 Procedural Statistics http://www.surgery.org/sites/default/files/ASAPS-Stats2015.pdf Accessed November 29, 2016.
-
- Email communication from the Director of Practice Development, RealSelf to Steven Teitelbaum, MD, September 8, 2016.
-
- Cárdenas-Camarena L, Bayter JE, Aguirre-Serrano H, Cuenca-Pardo J. Reply: Deaths Caused by Gluteal Lipoinjection: What Are We Doing Wrong? Plast Reconstr Surg. 2016;137(3):642e-643e. - PubMed
-
- Astarita DC, Scheinin LA, Sathyavagiswaran L. Fat transfer and fatal macroembolization. J Forensic Sci. 2015;60(2):509-510. - PubMed
-
- NBC 6 Investigation Prompts Worldwide Warning http://www.nbcmiami.com/news/local/NBC-6-Investigation-Prompts-Worldwide... Accessed November 29, 2016.
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