Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2025; 13(2): 97834
Published online Jan 16, 2025. doi: 10.12998/wjcc.v13.i2.97834
Cerebral fat embolism following autologous fat injection in facial reconstruction: A case report
Xiu-Ying Chen, Fa Shen, Chang Cheng, Yu-Han Wang, Wen-Chao Cheng, De-Zhi Yuan, Wen Huang
Xiu-Ying Chen, Fa Shen, De-Zhi Yuan, Wen Huang, Department of Neurology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing 400000, China
Chang Cheng, Yu-Han Wang, Wen-Chao Cheng, Department of Neurology, Xinqiao Hospital, The Army Medical University (Third Military Medical University), Chongqing 400000, China
Author contributions: Shen F, Cheng C, Wang YH, Cheng WC, and Yuan DZ collected the clinical data and generated the figures; Chen XY wrote the original manuscript; Huang W reviewed and edited the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Supported by The National Natural Science Foundation of China, No. 82171334; and The Chongqing Science and Health Joint Medical Research Project, No. 2024MSXM155.
Informed consent statement: Written informed consent from the patients/participants or patients/participants’ legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements. Written informed consent was obtained from the individual.
Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen Huang, MD, PhD, Director, Doctor, Full Professor, Department of Neurology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, No. 1 Jiankang Road, Yuzhong District, Chongqing 400010, China. huangmy0603@163.com
Received: June 10, 2024
Revised: September 20, 2024
Accepted: October 25, 2024
Published online: January 16, 2025
Processing time: 150 Days and 12.4 Hours
Abstract
BACKGROUND

Autologous fat injection in facial reconstruction is a common cosmetic surgery. Although cerebral fat embolism (CFE) as a complication is rare, it carries serious health risks.

CASE SUMMARY

We present a case of a 29-year-old female patient who developed acute CFE following facial fat filling surgery. After the surgery, the patient experienced symptoms including headache, nausea, vomiting, and difficulty breathing, which was followed by neurological symptoms such as slurred speech and left-sided weakness. Comprehensive physical examination and auxiliary investigations, including blood tests, head and neck computed tomography angiography, and cranial magnetic resonance diffusion-weighted imaging, were performed upon admission. The clinical diagnosis was acute cerebral embolism following facial fat filling surgery. Treatment included measures to improve cerebral circulation, dehydration for intracranial pressure reduction, nutritional support, and rehabilitation therapy for left limb function. The patient showed a significant improvement in symptoms after 2 weeks of treatment. She recovered left limb muscle strength to grade 5, had clear speech, and experienced complete relief of headache.

CONCLUSION

Our case highlights the potential occurrence of severe complications in patients undergoing fat injection in facial reconstruction. To prevent these complications, plastic surgeons should enhance their professional knowledge and skills.

Keywords: Cerebral fat embolism; Mechanical thrombectomy; Thrombolysis; Steroid therapy; Symptomatic treatment; Case report

Core Tip: Our case highlighted the potential occurrence of severe and potentially life-threatening complications in patients undergoing autologous fat injection in facial reconstruction. To prevent and manage such serious complications, plastic surgeons need to enhance their professional knowledge and skills. It is advisable to use blunt needles and inject slowly under low pressure during autologous fat injection, ensuring continuous aspiration to confirm the absence of blood during injection.