Pulmonary Fat Embolism Following Liposuction and Fat Grafting: A Review of Published Cases.

[BACKGROUND] One of the most severe complications of liposuction and fat grafting is pulmonary fat embolism (PFE). However, most healthcare workers are not familiar with PFE. We performed a systematic review to describe the details of PFE.

[METHODS] PubMed, EMBASE, and Google Scholar were searched up to October 2022. Further analysis focused on clinical, diagnostic, and outcome parameters.

[RESULTS] A total of 38 patients from 20 countries were included. Chest computed tomography (CT) yielded 100% accuracy in the diagnosis of PFE. All of the deceased died within 5 days after surgery, and in 76% of patients, onset of symptoms occurred within 24 h after surgery. The proportions of patients who required mechanical ventilation, had a cardiac arrest event, or died among all patients and among those whose onset of symptoms occurred within 24 h after surgery were 75%, 38%, and 33% versus 79%, 56%, and 43%, respectively.

[CONCLUSIONS] The earlier the onset of symptoms was, the more severe the clinical course was. Once a patient presents with PFE-related symptoms, surgery should be halted, supportive care initiated, and chest CT used to diagnose PFE. According to our review results, if a patient with PFE survives the initial episode without permanent sequelae, a complete recovery can be anticipated.