Facial filler causes stroke after development of cerebral fat embolism

A 35-year-old woman complaining of weakness of her left arm and leg was admitted to our hospital. She said the problem started 25 h earlier, soon after liposuction on her left thigh and a filler injection of the fat into her face in a beauty salon. The woman was previously healthy with no medical history. On physical examination we found hemiplegia of the left limbs: muscle strength was 1/5 in the arm and 3/5 in the leg. She had left central facial palsy and clear speech, and was cognitively intact. Bilateral Babinski signs were negative and there were no features of meningeal irritation. The patient's blood pressure, pulse rate, and temperature were in the normal ranges. Routine blood tests, blood lipids, glucose concentration, and electrolytes were also normal. An electrocardiogram and a transthoracic echocardiogram showed no abnormalities.