Abstract：
BACKGROUND: With the increasing use of autologous fat (AF) grafting in plastic surgery, the occurrence of complications has garnered the attention from plastic surgeons. This study aims to estimate the cerebral complications following facial AF graft injection objectively and systematically with newly published literature.
METHODS: A comprehensive literature search was conducted systematically on PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov for articles published between 2000 and 2023. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines.
RESULTS: A total of 11 articles comprising of 37 participants were included, all of which are case reports. For AF facial filling, the incidence rate of cerebral embolism among cases of cerebral and ocular embolism was found to be 60% (95% CI 0.41-0.79). The incidence of cerebral embolism presenting with initial symptoms of unconsciousness was 69% (95% CI 0.48-0.9), with limb movement disorders was 55% (95% CI 0.26-0.84), and with vision loss was 30% (95% CI 0.12-0.49). The incidence of cerebral embolism with ophthalmic artery occlusion was 36% (95% CI 0.20-0.53), compared to was 71% (95% CI 0.48-0.95) without ophthalmic artery occlusion.
CONCLUSIONS: AF grafting is generally safe and minimally invasive. However, with its widespread use as facial injection filling for cosmetic enhancement, the incidence of cerebral complications, such as cerebral infarction, has also increased. It is imperative to properly manage high-risk factors for cerebral embolism during the perioperative period to prevent its occurrence.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: A comprehensive literature search was conducted systematically on PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov for articles published between 2000 and 2023. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines.
RESULTS: A total of 11 articles comprising of 37 participants were included, all of which are case reports. For AF facial filling, the incidence rate of cerebral embolism among cases of cerebral and ocular embolism was found to be 60% (95% CI 0.41-0.79). The incidence of cerebral embolism presenting with initial symptoms of unconsciousness was 69% (95% CI 0.48-0.9), with limb movement disorders was 55% (95% CI 0.26-0.84), and with vision loss was 30% (95% CI 0.12-0.49). The incidence of cerebral embolism with ophthalmic artery occlusion was 36% (95% CI 0.20-0.53), compared to was 71% (95% CI 0.48-0.95) without ophthalmic artery occlusion.
CONCLUSIONS: AF grafting is generally safe and minimally invasive. However, with its widespread use as facial injection filling for cosmetic enhancement, the incidence of cerebral complications, such as cerebral infarction, has also increased. It is imperative to properly manage high-risk factors for cerebral embolism during the perioperative period to prevent its occurrence.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：随着在整形外科中越来越多地使用自体脂肪（AF）移植，并发症的发生引起了整形外科医生的注意。本研究旨在通过新发表的文献客观，系统地评估面部AF移植物注射后的大脑并发症。
方法：在PubMed，Embase,WebofScience,科克伦,和ClinicalTrials.gov在2000年至2023年之间发表的文章。根据PRISMA指南进行系统评价和荟萃分析。
结果：共纳入11篇文章，包括37名参与者，所有这些都是病例报告。对于AF面部填充，发现脑栓塞和眼栓塞病例中脑栓塞的发生率为60％（95％CI0.41-0.79）。以昏迷为首发症状的脑栓塞发生率为69%(95%CI0.48-0.9),肢体运动障碍患者为55%(95%CI0.26-0.84)，视力下降为30%（95%CI0.12-0.49）。眼动脉闭塞脑栓塞的发生率为36％（95％CI0.20-0.53），没有眼动脉闭塞的比例为71%(95%CI0.48-0.95)。
结论：AF移植通常是安全和微创的。然而,它广泛用作面部注射填充剂，用于美容增强，大脑并发症的发生率，比如脑梗塞，也增加了。围手术期做好脑栓塞的高危因素防治势在必行。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：在PubMed，Embase,WebofScience,科克伦,和ClinicalTrials.gov在2000年至2023年之间发表的文章。根据PRISMA指南进行系统评价和荟萃分析。
结果：共纳入11篇文章，包括37名参与者，所有这些都是病例报告。对于AF面部填充，发现脑栓塞和眼栓塞病例中脑栓塞的发生率为60％（95％CI0.41-0.79）。以昏迷为首发症状的脑栓塞发生率为69%(95%CI0.48-0.9),肢体运动障碍患者为55%(95%CI0.26-0.84)，视力下降为30%（95%CI0.12-0.49）。眼动脉闭塞脑栓塞的发生率为36％（95％CI0.20-0.53），没有眼动脉闭塞的比例为71%(95%CI0.48-0.95)。
结论：AF移植通常是安全和微创的。然而,它广泛用作面部注射填充剂，用于美容增强，大脑并发症的发生率，比如脑梗塞，也增加了。围手术期做好脑栓塞的高危因素防治势在必行。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
