Sepsis with multiple abscesses after massive autologous fat grafting for augmentation mammoplasty: a case report.
BACKGROUND
Autologous fat grafting to the breast for breast reconstruction and cosmetic breast augmentation has gained much attention recently. However, its efficacy and the severities of its associated complications are of concern. The authors experienced one case of multiple breast abscesses after augmentation mammoplasty by autologous fat grafting.


METHODS
A 42-year-old woman presented to the authors' emergency department reporting tenderness, swelling, and a sensation of heat in both breasts. The patient had undergone augmentation mammoplasty by autologous fat grafting 7 days previously. Abscess formation was suspected based on the patient's history, physical examination, laboratory findings, and image study.


RESULTS
Incision and drainage were performed immediately with the patient under general anesthesia, and 500 ml of a foul, brown, turbid, purulent fluid containing necrotic fat debris was drained from each breast. Empiric antibiotics were started on the first hospital day, and betadine and saline-irrigation were administered daily for 2 weeks. Incisions were closed on hospital day 19 when laboratory data and local infection signs had improved. At the patient's 9-month follow-up assessment, breast contours were found to be well preserved, and scarring was minimal.


CONCLUSIONS
Immediate complications such as edema, hematoma, and infection require serious consideration after autologous fat grafting in the breast. In particular, infection probably is the most serious complication because the volume of the fat injected is large and can induce systemic infections such as sepsis and distort the contours of the breast. To avoid such infections, systemic and multicenter studies are required to determine how fat grafting should be performed to minimize the risks of fat necrosis and infection.
Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Woncheon-Dong, Yeongtong-Gu, Suwon, Gyeongi-Do 443-721, Korea.
Keu Sung
KS
Lee
Seung Jo
SJ
Seo
Myong Chul
MC
Park
Dong Ha
DH
Park
Chee Sun
CS
Kim
Young Moon
YM
Yoo
Il Jae
IJ
Lee
D000038:Abscess / Q000209:etiology / Q000628:therapy*; D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001940:Breast / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D018805:Sepsis / Q000209:etiology / Q000628:therapy*; D007507:Therapeutic Irrigation; D014182:Transplantation, Autologous / Q000009:adverse effects
D000900:Anti-Bacterial Agents