Objective. To review the modern data on major complications following fat grafting; to analyze the incidence, causes, prevention and treatment of these complications.

Material and methods. We have analyzed 22 references on major complications of fat grafting. The most dangerous complications followed by high risk of mortality and irreversible severe functional and aesthetic injury were distinguished. Statistical data, possible mechanisms, prevention and treatment were described.

Results. Venous embolism, arterial embolism, nerve injury and major infection are the most dangerous adverse events following fat grafting. These conditions were comprehensively described. Safety of fat injections in cancer patients was discussed as well.

Conclusion. Recent scientific data on the most dangerous complications of fat grafting were summarized in this manuscript. Understanding the causes and mechanisms is essential to elaborate certain safety criteria of lipofilling in various anatomical areas. Correct lipofilling technique increases clinical safety of this procedure.

Keywords. fat grating, lipofilling, brazilian butt lift, major complications, venous embolism, arterial embolism, nerve injury, oncological safety