Anxiety 2 days before Liposuction, and concerned about fat embolisms. What is the actual cause?

I am having major anxiety about my liposuction procedure in 2 days. It is waking me at night and giving me heart plalpitions during the day. I had a complete heart work up and everything came back normal except for minor PVC's. I am worried about anesthesia but more concerned after reading about fat embolisms. What is the major cause of this? Is it when too much fat is removed, or no real known cause? How concerning is complication with liposuction? Thanks.

Doctor Answers 9


Hello and thank you for your question. If good technique is used, the risk of fat embolism is so extremely rare.  Liposuction is a very commonly performed procedure and is extremely safe if performed by a plastic surgeon board-certified by the American Board of Plastic Surgery.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Anxiety 2 days before Liposuction, and concerned about fat embolisms. What is the actual cause?


Thank you for your question: After the liposculpture operation the recovery period depends on your physical status, age, general health and condition mainly. The operation itself does not take too long therefore you receive a mild anesthesia. Since the anesthesia that you receive is mild; you will not have problems associated with anesthetic agents after the operation. This is especially important and can be achieved with only a team of plastic surgeons like we have. After the operation you will have stiches and bandages on the inner parts of your extremities which will be removed after the 10th day. You can start to do your daily activities just after the operations but we do not advise you heavy lifting, running or activities that require excess physical activity. The more you rest, the faster your recovery will be.

Anxiety 2 days before Liposuction, and concerned about fat embolisms. What is the actual cause?

Thank you for you question. It is normal to have anxiety before your surgery.  Make sure your surgeon is a board certified plastic surgeon.  Discuss your concerns with your surgeon for reassurance.  There is risks with any surgery.  Best wishes. 

Liposuction and fat embolism

Thank you for asking about your liposuction.

  • First, please let your plastic surgeon know of your anxiety. S/he may be able to reassure you.
  • Please be sure your treatment will be by a qualified plastis surgeon.
  • Fat embolism occurs when fat gets into the blood vessels. It can be immediately fatal.
  • Although in very large volume liposuction, the risk increases, probably done moderate volume liposuction is very unlikely to cause this.
  • The injection of fat however - as with a BBL - can cause this complications and is one reason that great caution is used in doing this procedure.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Try Not to Worry!

Liposuction is extremely safe and your risk of a heart embolism is very rare. I recommend talking to your Dr. about your concerns in order to allay your fears so you can focus on healing and getting great results. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Liposuction and Fat Embolism

Liposuction is body-contouring procedure that uses suction to remove stubborn fat deposits from under this skin. Because there is a constant suction, fat embolism during liposuction is very rare. 

This is compared to fat transfer where the fat is injected into the tissues under pressure. During fat transfer, if fat is injected in the wrong location, the fat can end up in a blood vessel - causing a fat embolism. 

A frank discussion with your board certified plastic surgeon would be the next best step.

For more info on Liposcution, see the link below.

Liposuction and Fat Emboli

Liposuction is a very safe procedure. The risk of fat emboli is exceedingly rare.

With the rise of fat transfer and the "BBL," the phenomenon of fat embolus has risen to the forefront. Fat emboli technically refers to a situation in which adipose/fat tissue (which is normally extravascular or outside of the vascular/vessel space) is introduced into the intra-vascular space. This emboli can then travel within the vessel downstream causing an occlusion. This is a very serious complication which requires immediate medical attention. 

The risk of fat embolus is very, very low for liposuction alone, however, the risk is higher in the setting of fat transfer (in which fat is re-injected into an area rich with large vessels). Special care must be taken to ensure that there is no inadvertent intra-vascular injection. Some techniques include aspiration before injection, use of blunt cannulas for transfer and avoiding intra-muscular injection (lower incidence of vessel cannulation).

As always, discuss your concerns with aboard certified plastic surgeon.

Donovan Rosas, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 7 reviews


Fat embolism is caused by introduction of fat into a blood vessel which then flows to a distant organ and causes a stroke or other problem. Its very very rare.  Liposuction is the most common plastic surgery procedure (after botox and fillers) and is done over 100,000 times a year. While complications can happen, I wouldn't lose sleep. Good luck

Robert Frank, MD
Munster Plastic Surgeon
5.0 out of 5 stars 31 reviews

Anxiety 2 days before Liposuction, and concerned about fat embolisms. What is the actual cause?

I am sorry to hear about your heightened anxiety and concerns regarding your upcoming liposuction.  I have been performing the procedure for approximately 35 years and have never had a fat embolism in a liposuction procedure.  Assuming you are not having fat transfer I think it really is an extremely minor risk that should not be cause for anxiety.  There have been reports of fat emboli from fat augmentation especially into the buttock area but if you are not undergoing this procedure I think I can allay your concerns.

It is my feeling that your recovery and experience will be smoother and better if you can reduce your anxiety state before undergoing anesthesia.  If you feel you need to, contact your plastic surgeon to review all of your questions as soon as possible.  Rarely plastic surgeons prescribe an anti-anxiety medication to take the night before surgery to allow you to get some sleep and rest.

Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.