UNEXPECTED OUTCOME Surgeons had finished the elongation part of the procedure and were in the process of transferring fat to the patient's penis when complications arose.

A penile enlargement procedure proved fatal for a 30-year-old man at a surgical facility in Sweden when fat injected into his penis traveled to the lungs and caused blood vessels to rupture. It was the first time a seemingly simple and safe penis enhancement surgery involving autologous fat transfer resulted in the sudden death of a healthy, young patient, according to forensic medicine researchers.

The patient went to a plastic surgery clinic in Stockholm for a 2-part surgical procedure: penile elongation, followed by girth enhancement surgery, which includes transferring fat from one area of the body to the shaft of the penis. Surgeons had finished the elongation part of the procedure and were in the process of transferring fat harvested from the lower abdomen to the penis when complications arose, according to a study published in the Journal of Forensic Sciences.

The man's heart began to race, his blood pressure plummeted and ultimately he suffered a heart attack. He was then transferred to an emergency hospital, where he died within 2 hours of showing the first signs of distress. He had no past medical history other than asthma, the study shows. The authors of the study attribute his death to the attempt to add length and girth to the penis during the same procedure.

A 2012 study deemed the use of autologous fat injection for penile girth enhancement safe and effective, without major complications. But performing girth enhancement on pre-traumatized tissue — in this case, after an elongation procedure — may be too risky, say the authors of the study.

Pulmonary fat embolization, which is also a common side effect of procedures such as the Brazilian butt lift, results from fat droplets entering systemic circulation after a traumatic event, including some surgeries. But usually, the authors say, it has no clinical relevance.

Bill Donahue