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Microscopic and Macroscopic Fat Embolism: Solving the Puzzle with Case Reports

Durán, Héctor, M.D.; Cárdenas-Camarena, Lázaro, M.D.; Bayter-Marin, Jorge Enrique, M.D.; Ramos-Gallardo, Guillermo, M.D.; Robles-Cervantes, José Antonio, M.D.

Plastic and Reconstructive Surgery: October 2018 - Volume 142 - Issue 4 - p 569e-577e
doi: 10.1097/PRS.0000000000004810
Plastic Surgery Focus: Special Topics
Patient Safety CME

Background: The frequency of fat embolism mortality after liposuction has increased. As the only dependable evidence for this problem is that available in the medical literature, a study of clinical case reports is warranted.

Methods: The authors reviewed the medical literature by searching for case reports of fat embolism after liposuction in humans who manifested either of the variants of the condition: microscopic fat embolism or macroscopic fat embolism. The authors performed a literature search of the PubMed and PubMed Central databases from the first case of fat embolism syndrome associated with liposuction reported until March of 2017; keywords Fat Embolism (Fat Embolism Syndrome), Liposuction, and Case (((fat embolism) AND liposuction) AND case) were used. A detailed analysis of the data contained in the clinical case reports was conducted.

Results: In total, 39 and 98 articles were found in PubMed and PubMed Central, respectively, using the keywords (((Fat + Embolism) + AND + Liposuction) + AND + Case). After analysis, only 15 reports corresponded to cases of macroscopic or microscopic fat embolism after liposuction, and the basic statistics of the two proposed variants were examined.

Conclusions: This work provides relevant information regarding very important characteristics of microscopic and macroscopic fat embolism. Despite the diagnostic difficulty, clinical diagnosis remains the gold standard for identifying microscopic and macroscopic fat embolism. The establishment of a rapid and timely diagnosis is of great help for appropriate treatment.

Patient Safety CME.

Mérida, Yucatán; and Zapopan and Puerto Vallarta, Jalisco, México; and Bucaramanga, Colombia

From private practice; the Divisions of Plastic Surgery and Internal Medicine, Jalisco Institute of Reconstructive Surgery “Dr. José Guerrerosantoss”; the Jalisco College of Plastic, Esthetic and Reconstructive Surgery; and Clínica “El Pinar.”

Received for publication October 30, 2017; accepted April 13, 2018.

Disclosure:The authors have no financial interest to disclose. No funding was received for this article.

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Héctor Durán, M.D., Calle 54 No. 365 Int. 317, Centro Médico de las Américas, Colonia Centro, Mérida, Yucatán, México CP 97000,

Copyright © 2018 by the American Society of Plastic Surgeons