The Perfect Storm: Fat Embolism Syndrome Following Liposuction, Helium Radiofrequency, and Targeted Cellulite Subcision.

This is a case report of fat embolism syndrome (FES), where fatty micro-fragments lodge into pulmonary capillaries damaging alveoli and causing respiratory insufficiency immediately following the combination of liposuction, helium radiofrequency (HRF), and targeted cellulite subcision of the thighs in a 51-year-old woman. FES is to be distinguished from macroscopic fat embolism, which causes mechanical obstruction of venous vasculature and sudden cardiac failure. FES is the sequelae of microscopic fat emboli affecting the lungs, brain, and skin and is characterized by acute onset of hypoxia and a diffuse ground-glass appearance on computed tomography. In this report, the authors theorize the possible mechanism created by the combination of subcision, power-assisted liposuction, and HRF, which might have led to FES. They also share potential safety considerations when using these multiple modalities. Level of Evidence: 5 (Therapeutic).