The pathogenesis of the fat embolism syndrome (FES) is the subject of conjecture and controversy. Fat embolism syndrome (FES) is a group of findings that arise from a single, unified cause: the escape of fat globules into the circulation (fat embolism). The ultimate resting places of those globules determine the specific manifestations of FES seen in clinical practice. When it occurs, it typically becomes apparent 24 - 27 hours after injury. The good news is that there is a very rare chance for the occurrence of fat embolism during or after chin lipo.Most patients with FES recover fully without residual deficits. Mortality rate varies from 5% to 15% in various studies. However, older patients with numerous comorbid medical conditions, and diminished physiologic reserve have more terrible results. The fulminant form of FES displays as acute coronary pulmonale, respiratory failure or embolism, and prompting to death of patient inside few hours of injury.