Granulomatous reaction to autologous gluteal fat transfer

Abstract

Autologous fat transfer is an increasingly popular surgical procedure with many applications in the cosmetic realm and beyond. It is found to be an efficacious procedure, but there is growing concern over adverse effects.1, 2 Potential risks include common complications such as fat necrosis, seroma formation, and cellulitis.1 More serious complications have also been reported, including life-threatening infections and potentially fatal fat emboli, especially in gluteal fat transfer.1, 3 The American Society of Plastic Surgeons recently issued a warning identifying gluteal fat grafting as the aesthetic procedure with the highest mortality rate (1 in 3000 procedures).4 Historically, use of silicone for gluteal enhancement has resulted in numerous cases of granulomatous foreign body–like reactions.5, 6 Theoretically, the use of autologous tissue would decrease the incidence of these reactions. Here we report the first case, to our knowledge, of a granulomatous reaction to autologous fat transfer in the gluteal region.