private practice in Bucaramanga, Colombia.
Division of Plastic Surgery, Hospital Innovare, Zapopan, Jalisco, México Dr. José "Guerrerosantos," Zapopan, Jalisco, México.
Aesthet Surg J. 2019 Aug 22;39(9):NP380-NP383. doi: 10.1093/asj/sjz151.
Gluteal augmentation with fat has become one of the most common cosmetic procedures worldwide. Gluteal augmentation is designed to increase the volume and contour of the gluteal region. Intramuscular lipoinjection has been linked to multiple reports of severe complications, including death due to macro fat embolism (MAFE). The authors present the first reported case of survival and successful recovery after MAFE secondary to gluteal augmentation with fat. A 41-year-old woman, ASA II, was scheduled for augmentation mammaplasty, liposuction, and gluteal augmentation with fat. The patient was operated under general anesthesia with a total intravenous anesthesia technique. A total of 3.5 liters of fat was liposuctioned with no complications. The patient was then positioned in a lateral decubitus position for gluteal augmentation with fat. Right after the last injection, the anesthesiologist noticed a sudden change in capnography followed by hypotension, bradycardia, and hypoxemia. The first reaction in the operating room was to consider that the patient was experiencing a severe episode of fat embolism. She was then resuscitated and transferred to a tertiary facility for intensive care management. To our knowledge, this is the first case report of successful resuscitation in a patient experiencing severe MAFE after gluteal augmentation with fat. We believe that this patient survived the event due to early detection, aggressive management, and proper transfer to an intensive care unit. Level of Evidence: 5.
臀部脂肪填充已成为全球最常见的美容手术之一。臀部脂肪填充旨在增加臀部区域的体积和轮廓。肌肉内脂肪注射与多种严重并发症相关，包括因巨块脂肪栓塞（MAFE）导致的死亡。作者报告了首例因臀部脂肪填充而发生 MAFE 后存活并成功康复的病例。一名 41 岁女性，ASA II 级，拟行隆乳术、吸脂术和臀部脂肪填充术。患者全身麻醉下采用全静脉麻醉技术进行手术。共抽吸 3.5 升脂肪，无并发症。然后将患者置于侧卧位进行臀部脂肪填充。就在最后一次注射后，麻醉师注意到二氧化碳描记图突然变化，随后出现低血压、心动过缓和低氧血症。手术室的第一反应是认为患者正在经历严重的脂肪栓塞事件。随后对其进行复苏并转至三级设施进行重症监护管理。据我们所知，这是首例报告的在臀部脂肪填充后发生严重 MAFE 的患者成功复苏的病例。我们认为，该患者由于早期发现、积极管理和适当转至重症监护病房而存活下来。证据等级：5。
