Aesthetic Plastic Surgery

, Volume 35, Issue 4, pp 641–645 | Cite as

Sepsis With Multiple Abscesses After Massive Autologous Fat Grafting for Augmentation Mammoplasty: A Case Report

  • Keu Sung Lee
  • Seung Jo Seo
  • Myong Chul Park
  • Dong Ha Park
  • Chee Sun Kim
  • Young Moon Yoo
  • ll Jae Lee
Case Report



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.


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.


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.


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.


Augmentation mammaplasty Breast Fat graft Sepsis 


  1. 1.
    Neuber GA (1893) Fett transplantation. Verh Dtsch Ges Chir Long Vern 22:66Google Scholar
  2. 2.
    Bircoll M (1987) Cosmetic breast augmentation utilizing autologous fat and liposuction technique. Plast Reconstr Surg 79:267–271PubMedCrossRefGoogle Scholar
  3. 3.
    Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367PubMedGoogle Scholar
  4. 4.
    Spear SL, Wilson HB, Lockwood MD (2005) Fat injection to correct contour deformities in the reconstructed breast. Plast Reconstr Surg 5:1300–1305CrossRefGoogle Scholar
  5. 5.
    ASPRS Ad-Hoc Committee on New Procedures (1987) Report on autologous fat transplantation. Plast Surg Nurs 7:140–141Google Scholar
  6. 6.
    Missana MC, Laurent I, Barreau L, Balleyguier C (2007) Autologous fat transfer in reconstructive breast surgery: indications, technique, and results. Eur J Surg Oncol 33:685–690PubMedCrossRefGoogle Scholar
  7. 7.
    Castello JR, Barros J, Vazquez R (1999) Giant liponecrotic pseudocyst after breast augmentation by fat injection. Plast Reconstr Surg 103:291–293PubMedCrossRefGoogle Scholar
  8. 8.
    Hyakusoku H, Ogawa R, Ono S, Ishii N, Hirakawa K (2009) Complications after autologous fat injection to the breast. Plast Reconstr Surg 123:360–370PubMedCrossRefGoogle Scholar
  9. 9.
    Fulton JE (2003) Breast contouring with “galled” autologous fat: a 10-year update. Int J Cosmet Surg Aesthet Dermatol 5:155–163CrossRefGoogle Scholar
  10. 10.
    Coleman SR, Saboeiro AP (2007) Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg 119:775–785PubMedCrossRefGoogle Scholar
  11. 11.
    Valdatta L, Thione A, Buoro M, Stefania T (2001) A case of life-threatening sepsis after augmentation by fat injection. Aesthet Plast Surg 25:347–349CrossRefGoogle Scholar
  12. 12.
    Petkovsek Z, Elersic K, Gubina M, Zgur-Bertok D, Starcic Erjavec M (2009) Virulence potential of Escherichia coli isolates from skin and soft tissue infections. J Clin Microbiol 47:1811–1817PubMedCrossRefGoogle Scholar
  13. 13.
    Moet GJ, Jones RN, Biedenbach DJ, Stilwell MG, Fritsche TR (2007) Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: Report from the SENTRY Antimicrobial Surveillance Program (1998–2004). Diagn Microbiol Infect Dis 57:7–13PubMedCrossRefGoogle Scholar
  14. 14.
    von Heimburg D, Lemperle G, Dippe B, Krüger S (1994) Free transplantation of fat autografts expanded by tissue expanders in rats. Br J Plast Surg 47:470–476CrossRefGoogle Scholar
  15. 15.
    Carpaneda CA, Ribeiro MT (1994) Percentage of graft viability versus injected volume in adipose autotransplants. Aesthet Plast Surg 18:17–19CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010

Authors and Affiliations

  • Keu Sung Lee
    • 1
  • Seung Jo Seo
    • 2
  • Myong Chul Park
    • 2
  • Dong Ha Park
    • 2
  • Chee Sun Kim
    • 2
  • Young Moon Yoo
    • 2
  • ll Jae Lee
    • 2
  1. 1.Department of Pulmonary and Critical Care MedicineAjou University School of MedicineSuwonKorea
  2. 2.Department of Plastic and Reconstructive SurgeryAjou University School of MedicineSuwonKorea

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