Autologous fat injection is becoming a more and more widely accepted procedure in plastic surgery nowadays. Concomitantly, there are many complications. The most serious one is arterial fat embolism, for which there is only poor prognosis and no effective treatment. Here, we report the first case of successful treatment of cerebral fat embolization with the help of mechanical lipectomy. Our patient was found unconscious with left-sided hemiparesis after a facial fat injection surgery 4 hours before. Cerebral artery computed tomography angiography indicated it was multiple fat embolism. Then Solitaire stent (4 × 20 mm) and Solumbra (continuously negative pressure attraction) were utilized for the mechanical extraction of fat emboli. The patient recovered from left-side hemiparesis to muscle strength of Medical Research Council scale grade 4, and National Institutes of Health Stroke Scale score was 0 after 3 months visit. In the cerebral infarction after fat transplantation, mechanical lipectomy can be a novel and significant treatment.