{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:16:51Z","timestamp":1784186211368,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Severe cerebral artery embolism is a rare complication of facial autologous fat injection. However, its incidence has markedly increased with the recent rise in facial cosmetic procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report a 31-year-old Chinese woman who presented with unconsciousness 6 h after having undergone a facial autologous fat injection. A neurological examination revealed stupor, bilaterally diminished pupillary light reflexes, right-sided central facial palsy, and no reaction to pain stimulation of right limbs. Diffusion-weighted imaging displayed patchy hyperintense lesions in the left frontal, parietal, and temporal lobes. Magnetic resonance angiography demonstrated fat embolism in the left internal carotid artery, anterior cerebral artery, and middle cerebral artery. We immediately performed mechanical thrombectomy under sufficient preoperative preparations but failed to achieve complete recanalization. Pathological examination of the embolus confirmed the presence of adipocytes. Although we actively administered symptomatic and supportive treatments, the patient eventually died due to the progression of cerebral herniation and systemic infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Due to the ineffectiveness of current treatment and the inferior prognosis, fat embolism, a severe complication of autologous fat graft, should draw the attention of both plastic surgeons and neurologists so that actions may be taken for both its prevention and treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1180333","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:08:31Z","timestamp":1691136511000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Case report and literature review: fatal cerebral fat embolism following facial autologous fat graft"],"prefix":"10.3389","volume":"14","author":[{"given":"Yawen","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gezhi","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangning","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhang","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfeng","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guogang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fude","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.amsu.2017.06.059","article-title":"Procedure, applications, and outcomes of autologous fat grafting","volume":"20","author":"Simonacci","year":"2017","journal-title":"Annals Med Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"S208","DOI":"10.1097\/SAP.0000000000002691","article-title":"Severe vascular complications caused by facial autologous fat grafting: a critical review","volume":"86","author":"Wang","year":"2021","journal-title":"Ann Plast Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J Clin Epi."},{"key":"B4","doi-asserted-by":"publisher","first-page":"Np162","DOI":"10.1093\/asj\/sjab193","article-title":"Cerebral embolism as a result of facial filler injections: a literature review","volume":"42","author":"Wang HC Yu","year":"2022","journal-title":"Aesthet Surg J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1136\/bjo.80.11.1026","article-title":"Sudden unilateral visual loss and brain infarction after autologous fat injection into nasolabial groove","volume":"80","author":"Lee","year":"1996","journal-title":"Br J Ophthalmol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.bjps.2018.09.010","article-title":"The infraorbital artery: clinical relevance in esthetic medicine and identification of danger zones of the midface","volume":"72","author":"Hufschmidt","year":"2019","journal-title":"J Plast Reconstr Aesthet Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1093\/asj\/sjz166","article-title":"The potential role of corticosteroid prophylaxis for the prevention of microscopic fat embolism syndrome in gluteal augmentations","volume":"40","author":"Safran","year":"2020","journal-title":"Aesthet Surg J."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004810","article-title":"Microscopic and macroscopic fat embolism: solving the puzzle with case reports","author":"Dur\u00e1n","year":"2018","journal-title":"Plast Reconstr Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1093\/asj\/sjab252","article-title":"Fat embolism after autologous facial fat grafting","volume":"42","author":"Dhooghe","year":"2022","journal-title":"Aesthet Surg J."},{"key":"B10","first-page":"273","article-title":"Ocular and cerebral ischemia following facial injection of autologous fat","volume":"5","author":"Danesh-Meyer","year":"2011","journal-title":"Retin Cases Brief Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"312","DOI":"10.3340\/jkns.2012.51.5.312","article-title":"Magnetic resonance findings in two episodes of repeated cerebral fat embolisms in a patient with autologous fat injection into the face","volume":"51","author":"Lee","year":"2012","journal-title":"J Korean Neurosurg Soc."},{"key":"B12","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.neurol.2018.01.382","article-title":"Cerebral fat embolism after autologous fat injection for reconstructive eye surgery","volume":"175","author":"Renard","year":"2019","journal-title":"Rev Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e2173","DOI":"10.1097\/GOX.0000000000002173","article-title":"Soft-tissue filler-associated blindness: a systematic review of case reports and case series","volume":"7","author":"Chatrath","year":"2019","journal-title":"Plast Reconstr Surg Glob Open."},{"key":"B14","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1093\/asj\/sjw132","article-title":"An anatomical analysis of the supratrochlear artery: considerations in facial filler injections and preventing vision loss","volume":"37","author":"Khan","year":"2017","journal-title":"Aesthet Surg J."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006313","article-title":"Evaluation of intra-arterial thrombolysis in treatment of cosmetic facial filler-related ophthalmic artery occlusion","author":"Zhang","year":"2020","journal-title":"Plast Reconstr Surg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s004150050177","article-title":"Middle cerebral artery occlusion AND ocular fat embolism after autologous fat injection in the face","volume":"245","author":"Feinendegen","year":"1998","journal-title":"J Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1212\/WNL.61.8.1151","article-title":"Acute fatal stroke immediately following autologous fat injection into the face","volume":"61","author":"Yoon","year":"2003","journal-title":"Neurology."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1097\/01.PRS.0000123627.33690.9E","article-title":"Cerebral fat embolism induced by facial fat injection","volume":"113","author":"Thaunat","year":"2004","journal-title":"Plast Reconstr Surg."},{"key":"B19","doi-asserted-by":"publisher","first-page":"358","DOI":"10.3341\/kjo.2011.25.5.358","article-title":"Ophthalmic artery obstruction and cerebralophthalmology","volume":"25","author":"Lee","year":"2011","journal-title":"KJO."},{"key":"B20","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/dsu.12426","article-title":"Sudden visual loss and multiple cerebral infarction after autologous fat injection into the glabella","volume":"40","author":"Hong","year":"2014","journal-title":"Dermatol Surg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"NP83","DOI":"10.1177\/1090820X14539973","article-title":"Internal and external carotid artery embolism following facial injection of autologous fat","volume":"34","author":"Wang","year":"2014","journal-title":"Aesthetic Surgery J."},{"key":"B22","first-page":"400","article-title":"case of sudden vision loss and multiple cerebral infarctions caused by autologous fat injection between eyebrows","volume":"8","author":"Chen","year":"2015","journal-title":"J Pract Dermatol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1007\/s00266-016-0681-2","article-title":"Massive cerebral infarction following facial fat injection","volume":"40","author":"Shen","year":"2016","journal-title":"Aesthetic Plast Surg."},{"key":"B24","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1080\/14764172.2016.1197400","article-title":"Acute mental change and hemiplegia after autologous fat injection","volume":"18","author":"Kang","year":"2016","journal-title":"J Cosmetic Laser Therapy Eur Soc Laser Dermatol."},{"key":"B25","first-page":"23","article-title":"One case of bilateral massive cerebral infarction during autologous fat injection in the temporal region","volume":"43","author":"Lu","year":"2017","journal-title":"J Lanzhou Univ."},{"key":"B26","first-page":"836","article-title":"Clinical study on artery embolization caused by cosmetic facial filler injections","volume":"10","author":"Wang","year":"2017","journal-title":"Chin J Stroke."},{"key":"B27","first-page":"249","article-title":"Two cases of acute cerebral infarction during facial autologous fat transplantation","volume":"51","author":"Ji","year":"2018","journal-title":"Chin J Neurol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.wneu.2018.08.148","article-title":"Cerebral fat embolism as complication of facial fat graft: retrospective analysis of clinical002Ccharacteristics, treatment, and prognosis","volume":"120","author":"Huo","year":"2018","journal-title":"World Neurosurg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1097\/SCS.0000000000004625","article-title":"Autologous fat used for facial filling can lead to massive cerebral infarction through middle cerebral artery or facial intracranial branches","volume":"29","author":"Wang","year":"2018","journal-title":"J Cranio Surgery."},{"key":"B30","first-page":"1028","article-title":"Liang GC, Li KS, Xian WC, Zhu YC, Peng YQ, Zhong WT. A case of massive cerebral infarction caused by facial autologous fat injection","volume":"29","author":"Liu","year":"2018","journal-title":"Hainan Med J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s00266-018-1265-0","article-title":"Internal carotid artery embolism after autologous fat injection for temporal augmentation","volume":"43","author":"Liu","year":"2019","journal-title":"Aesthetic Plastic Surg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/GOX.0000000000002091","article-title":"The successful mechanical lipectomy treatment of cerebral fat embolism following autologous fat injection","volume":"7","author":"Zhou","year":"2019","journal-title":"Plastic Reconst Surg Global Open"},{"key":"B33","first-page":"638","article-title":"Massive cerebral infarction caused by autologous fat injection in the forehead: a case report","volume":"35","author":"Li","year":"2019","journal-title":"Chin J Plastic Surg."},{"key":"B34","first-page":"899","article-title":"Case of mechanical thrombectomy for acute occlusion of internal carotid artery caused by facial contour plastic surgery and literature review","volume":"15","author":"Huo","year":"2020","journal-title":"Chin J Stroke."},{"key":"B35","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1097\/MD.0000000000019574","article-title":"Unusual clinicopathological presentation of nontraumatic cerebral fat embolism Two-case report","volume":"45","author":"Lee","year":"2020","journal-title":"Medicine"},{"key":"B36","first-page":"112","article-title":"A case of facial autologous fat transplantation complicated with massive cerebral infarction","volume":"44","author":"Xu","year":"2021","journal-title":"Shanghai Med J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.4103\/0028-3886.325333","article-title":"Acute visual loss and stroke following autologous fat injection into the temporal area","volume":"69","author":"Lu","year":"2021","journal-title":"Neurol India."},{"key":"B38","doi-asserted-by":"publisher","first-page":"6657","DOI":"10.3389\/fmed.2021.646657","article-title":"Case report and literature review: catastrophic embolism following cosmetic injection of autologous fat in the face","volume":"8","author":"Liu","year":"2021","journal-title":"Front Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"E215","DOI":"10.1097\/SCS.0000000000006898","article-title":"A massive right hemisphere infarction after autologous fat grafting for facial filling","volume":"32","author":"Miao","year":"2021","journal-title":"J Cranio Surg."},{"key":"B40","doi-asserted-by":"publisher","first-page":"610945","DOI":"10.3389\/fnhum.2021.610945","article-title":"Massive cerebral infarction following facial injection of autologous fat: a case report and review of the literature","volume":"15","author":"Qian","year":"2021","journal-title":"Front Hum Neurosci."},{"key":"B41","first-page":"50","article-title":"Clinical study of facial injection of hyaluronic acid or autologous fat with occlusion of ophthalmic artery and cerebral artery","volume":"11","author":"Liang","year":"2021","journal-title":"China Med Cosmetol."},{"key":"B42","first-page":"157","article-title":"Bilateral cerebral infarction caused by autologous fat facial filling: a case report and literature review","volume":"30","author":"Cui","year":"2022","journal-title":"Int J Cerebrovasc Dis."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1180333\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:08:51Z","timestamp":1691136531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1180333\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,4]]},"references-count":42,"alternative-id":["10.3389\/fneur.2023.1180333"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1180333","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,4]]},"article-number":"1180333"}}