Abstract
Liposuction, although generally safe, carries risks of rare but serious complications, such as pneumothorax and venous thromboembolism, as illustrated in the case of a 48-year-old woman who developed bilateral pulmonary embolism and left pneumothorax 6 days after vibration amplification of sound energy at resonance-assisted liposuction with mastopexy, despite appropriate thromboprophylaxis. Presenting with dyspnea, chest pain, and leg swelling, computed tomography pulmonary angiography confirmed the diagnoses, which were successfully managed with anticoagulation and conservative measures, highlighting both the potential for delayed complication presentation and the limitations of current prophylaxis protocols. This case underscores the importance of extended postoperative vigilance, particularly for combined respiratory and thromboembolic events, and reinforces the need for meticulous surgical technique, including blunt-tip cannula utilization in thoracic-area procedures, as well as thorough patient counseling about warning signs, because even guideline-compliant prevention may not eliminate risks in susceptible individuals undergoing body contouring surgery. Level of Evidence: 5 (Therapeutic).