Arch Plast Surg.  2018 Jan;45(1):14-22. 10.5999/aps.2017.01347.

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

• Lim KR
• Cho JM
• Yoon CM
• Lee KC
• Lee SY
• Ju MH

• KMID: 2403535
• DOI: http://doi.org/10.5999/aps.2017.01347

Abstract

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.

Keyword

Liposuction; Adipose tissue; Embolism; Fat embolism syndrome

MeSH Terms

Abdomen
Adipose Tissue
Anesthesia, General
Animals*
Brain
Embolism
Embolism, Fat*
Hemorrhage
Humans
Inflammation
Lipectomy*
Lung
Male
Models, Animal*
Pulmonary Embolism
Rats
Rats, Sprague-Dawley