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Deaths Caused by Gluteal Lipoinjection: What Are We Doing Wrong?

Cárdenas-Camarena, Lázaro M.D.; Bayter, Jorge Enrique M.D.; Aguirre-Serrano, Herley M.D.; Cuenca-Pardo, Jesús M.D.

Plastic and Reconstructive Surgery: July 2015 - Volume 136 - Issue 1 - p 58–66
doi: 10.1097/PRS.0000000000001364
Cosmetic: Original Articles
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Background: Intramuscular gluteal lipoinjection has become one of the most commonly used surgical procedures for achieving improvement in the gluteal contour; however, there are few studies that report and analyze the causes of secondary death from this surgical procedure.

Methods: An analysis of secondary deaths from gluteal lipoinjection procedures was performed in Mexico and Colombia over periods of 10 and 15 years, respectively. In Mexico, the study was performed through a survey of all members of the Mexican Association of Reconstructive, Plastic and Aesthetic Surgery. In Colombia, the study was performed through an analysis of deaths and autopsies documented by the National Institute of Legal Medicine and Forensic Sciences Regional Bogotá.

Results: A total of 413 Mexican plastic surgeons reported 64 deaths related to liposuction, with 13 deaths caused by gluteal lipoinjection. In Colombia, nine deaths were documented. Of the 13 deaths in Mexico, eight (61.6 percent) occurred during lipoinjection, whereas the remaining five (38.4 percent) occurred within the first 24 hours. In Colombia, six deaths (77.7 percent) occurred during surgery and three occurred (22.2 percent) immediately after surgery. In the Colombian autopsy results, seven cases of macroscopic fat embolism and two cases with a microscopic embolism were reported, with abundant fatty tissue in the infiltrated gluteal muscles.

Conclusions: In this study, the authors found that intramuscular gluteal lipoinjection is associated with mortality caused by gluteal blood vessel damage allowing macroscopic and microscopic fat embolism; therefore, buttocks lipoinjection should be performed very carefully, avoiding injections into deep muscle planes.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Guadalajara, Jalisco, México; and Bucaramanga and Bogotá, Colombia

From the Instituto Jaliscience de Cirugia Reconstructiva, INNOVARE Cirugía Plástica Especializada; Security Committee of the Mexican Association of Plastic Esthetic and Reconstructive Surgery; Anesthesiologist and Reanimation Critical and Intensive Care Medicine, Clínica “El Pinar”; and Universidad Nacional de Colombia, Instituto Nacional de Medicina Legal y Ciencias Forenses Regional Colombia.

Received for publication December 29, 2014; accepted January 30, 2015.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Lázaro Cárdenas-Camarena, M.D., INNOVARE Cirugía Plástica Especializada, Av Verona 7412, Col Villa Verona, Zapopan, Jalisco 45019, México, drlazaro@drlazarocardenas.com

©2015American Society of Plastic Surgeons