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Original Investigation
July 5, 2018

Association of Autologous Fat Injection in Facial Artery With Ophthalmological ComplicationsAn Experimental Animal Study

Author Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China
  • 2Department of Burn and Plastic Surgery, the 253rd hospital of PLA, Hohhot, Inner Mongolia, China
  • 3Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi, China
JAMA Facial Plast Surg. Published online July 5, 2018. doi:10.1001/jamafacial.2017.1975
Key Points

Question  What association does autologous fat filling have with ophthalmic function complications in rabbits?

Findings  In this rabbit study of 68 adult New Zealand white rabbits, harvested fat was injected as either minced fat, fat granules, or fat lipid and compared with saline. Minced fat was associated with more ophthalmic function complications than fat granules or fat lipid.

Meaning  Minced fat may be more likely to cause ophthalmic complications and mortality than fat granules and fat lipid in autologous fat filling.

Abstract

Importance  Complications caused by autologous fat filling have been reported. Comprehensive knowledge of the possible adverse effects of autologous fat filling is needed.

Objective  To determine the association of autologous fat filling with ophthalmic function complications.

Design, Setting, and Participants  Four adult New Zealand white rabbits were killed for a facial anatomy study. Sixty-four adult New Zealand white rabbits underwent fat harvest using the Coleman technique. Autologous fat was minced or digested with collagenase 1 and centrifuged to separate fat lipid and fat granules. Either 0.2 mL or 0.4 mL of minced fat, fat granules, fat lipid, or saline (control) was retrogradely injected into the facial artery of rabbit models. Electroretinography and ophthalmic fundoscopy were performed to measure the retina and fundus artery occlusions 2 weeks after surgery.

Main Outcomes and Measures  Visual impairment, blindness, and death.

Results  Injection of 0.2 mL of fat granules, fat lipid, and saline resulted in 100% (8 of 8), 62.5% (5 of 8), and 0 ophthalmic complications, respectively; and 0.4 mL resulted in 87.5% (7 of 8), 12.5% (1 of 8), and 0 ophthalmic complications, respectively. Injection of 0.2 mL and 0.4 mL minced fat led to 100% (8 of 8) ophthalmic complications and death, respectively. The mortality rates were 37.5% (3 of 8), 12.5% (1 of 8), and 0 for 0.2 mL emboli injection, and 100% (8 of 8), 50% (4 of 8), and 0 for 0.4 mL, respectively.

Conclusions and Relevance  In this study, minced fat injection was associated with more ophthalmic complications than injection of fat granules and fat lipid. Increasing the injection volume of fat tissues could raise the incidence of morbidity and mortality.

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