Major surgical interventions performed during plastic body correction carry significant risks for the patient's health. Among the factors that can provoke severe postoperative complications, experts name both blood loss and the risk of thrombosis due to the ingress of fat microparticles into the bloodstream during liposuction, and the prolonged action of strong drugs - all this puts a strong strain on the heart and blood vessels. Particular care should be taken when planning fat removal in elderly patients, as they often have diseases of the cardiovascular system. Estet-portal.com offers readers a description of a clinical case of the development of fat embolism after liposuction and the necessary steps to prevent further development of postoperative complications.
Clinical case of fat embolism after fat removal
Patient K., 55 years old, was admitted to the cardiology clinic due to the sudden development of fainting on the second day after plastic surgery for fat removal - abdominoplasty and liposuction.
Anamnesis. Plastic surgery was performed four days before admission to the clinic. The syncope developed suddenly while walking indoors and lasted about 10 seconds, after which the patient recovered spontaneously.
The patient complains of mild pain in the area of postoperative sutures, which she feels when changing the position of the body after removal of fat. History of life - without features. According to an objective examination during hospitalization, the postoperative sutures are clean, the skin with preserved turgor, moist, clean, moderate condition.
Results of laboratory and instrumental studies:
- dopplerography - increased pressure in the pulmonary artery up to 39 mm Hg. St.;
- radiography - there is diffuse infiltration of the lung tissue;
- general urinalysis - the presence of fat droplets;
- blood pressure - 70/40 mm Hg. Art., there is no violation of the heart rhythm;
- strongly positive fibrinogen - 375 mg%;
- ethanol test increase - from ++ to ++++.
Diagnosis. Based on the collected anamnesis, the patient's complaints, objective examination data, laboratory tests and instrumental studies, a clinical diagnosis was established: a mixed form of submassive fat embolism, syncope - developed after liposuction and abdominoplasty.
Treatment. The patient was prescribed: intravenous ceftriaxone and Essentiale 2 times a day, mildronate 1 time a day, clexane subcutaneously 1 time a day, tripas and rheosorbilact for 5 days once a day.
During the period of stay in the clinic, the syncope did not recur, a week later the sutures were removed, on the background of the treatment, fat droplets in the urine disappeared, the ethanol test decreased to +++, and the fibrinogen index to 275 mg/%. On the 8th day, the patient was discharged home with recommendations for maintenance treatment - taking Trifas, Mildronate and Essentiale for another month.
Conclusion. The likelihood of developing fat embolism after fat removal by surgical liposuction and abdominoplasty requires doctors of aesthetic clinics to take careful preventive measures on the eve of plastic surgery. It should be remembered that older patients who turn to plastic surgeons for body shaping are at risk for the development of cardiac complications, so it is recommended that a preliminary consultation with a cardiologist be carried out before prescribing abdominoplasty and liposuction in order to avoid severe postoperative complications.
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