Han Yimei, Liu Chen, Wu Guoping
Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146, Han-zhong Road, Nanjing, Jiangsu, People's Republic of China.
Department of Plastic and Cosmetic Surgery, Jiangsu Province Hospital of TCM, Nanjing, Jiangsu, People's Republic of China.
Aesthetic Plast Surg. 2024 Nov;48(22):4675-4686. doi: 10.1007/s00266-024-04268-8. Epub 2024 Aug 2.
With the increasing use of autologous fat (AF) grafting in plastic surgery, the occurrence of complications has garnered the attention from plastic surgeons. This study aims to estimate the cerebral complications following facial AF graft injection objectively and systematically with newly published literature.
A comprehensive literature search was conducted systematically on PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov for articles published between 2000 and 2023. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines.
A total of 11 articles comprising of 37 participants were included, all of which are case reports. For AF facial filling, the incidence rate of cerebral embolism among cases of cerebral and ocular embolism was found to be 60% (95% CI 0.41-0.79). The incidence of cerebral embolism presenting with initial symptoms of unconsciousness was 69% (95% CI 0.48-0.9), with limb movement disorders was 55% (95% CI 0.26-0.84), and with vision loss was 30% (95% CI 0.12-0.49). The incidence of cerebral embolism with ophthalmic artery occlusion was 36% (95% CI 0.20-0.53), compared to was 71% (95% CI 0.48-0.95) without ophthalmic artery occlusion.
AF grafting is generally safe and minimally invasive. However, with its widespread use as facial injection filling for cosmetic enhancement, the incidence of cerebral complications, such as cerebral infarction, has also increased. It is imperative to properly manage high-risk factors for cerebral embolism during the perioperative period to prevent its occurrence.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
随着自体脂肪（AF）移植在整形手术中的应用日益增多，并发症的发生已引起整形外科医生的关注。本研究旨在通过新发表的文献客观、系统地评估面部AF移植注射后的脑部并发症。
在PubMed、Embase、Web of Science、Cochrane和ClinicalTrials.gov上系统地全面检索2000年至2023年发表的文章。按照PRISMA指南进行系统评价和荟萃分析。
共纳入11篇文章，37名参与者，均为病例报告。对于AF面部填充，在脑和眼部栓塞病例中，脑栓塞的发生率为60%（95%CI 0.41-0.79）。以意识丧失为初始症状的脑栓塞发生率为69%（95%CI 0.48-0.9），以肢体运动障碍为初始症状的为55%（95%CI 0.26-0.84），以视力丧失为初始症状的为30%（95%CI 0.12-0.49）。伴有眼动脉闭塞的脑栓塞发生率为36%（95%CI 0.20-0.53），无眼动脉闭塞的为71%（95%CI 0.48-0.95）。
AF移植通常是安全且微创的。然而，随着其作为面部注射填充用于美容增强的广泛应用，脑并发症如脑梗死的发生率也有所增加。围手术期妥善管理脑栓塞的高危因素以预防其发生势在必行。
证据级别III：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级标准的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
