Liposuction of the Head and Neck
If one looks at the advances in cosmetic surgery over the past 20 years, liposuction would be high on the list, if not on top of the list. Prior to the advent of liposuction there were no simple options to remove accumulations of fat on the body. Liposuction changed all of that!
Liposuction is actually a very simple process. The fat tissues are first injected with a dilute solution of local anesthesia and epinephrine. This fluid is known as tumescent anesthesia. This fluid is injected to plump the tissues and make them firm. The effects of the fluid are to make the area numb, reduce bleeding and make the fat easier to suction. The actual suctioning process is straight forward. A small puncture is made in skin and a device called a cannula is inserted under the skin. This cannula is a tube with small holes and is connected to a vacuum source. The cannula is moved in rapid back and forth motions and it actually sucks the excess fat globules from under the skin. The fat then goes into a container and is discarded.
Although the actual procedure is simple, there are many nuances involved to have a successful result. An experienced liposuction surgeon knows how much fat to remove and how much to leave. The removal of too much fat can be problem. In addition, it takes a lot experience to perform the liposuction and achieve a smooth result. Inexperienced surgeons may leave a very irregular result with dimpling on the skin. It is important to leave the proper amount of fat under the skin. Too often we look at fat as the “enemy”, but in reality we must have a proper layer of fat under the skin to enable a smooth and youthful contour.
Unfortunately, many patients do not understand the use of liposuction. Some people think that it is a substitute for dieting and this is not true. Performing liposuction on an obese person will make unnatural contours. Liposuction is intended for those areas of fat that are resistant to weight loss. The saddle bags on the thighs or the area under the chin are good examples. The figure below illustrates common areas for genetic fat deposition on the face and neck.
The above image illustrates common areas of fat deposition on the face and neck.
On the face and neck, the area under the chin and the jowls (excess tissue on the side of the cheeks) are the most commonly treated areas with liposuction. One important factor to consider when evaluating a patient for facial liposuction is whether the problem is excess skin, excess fat or a combination of both. Liposuction will cause the skin to tighten and this is more common in younger patients. The patient shown below had liposuction only with nice tightening of the skin.
The above patient had nice improvment from liposuction only of the chin and neck. Younger patients get the best skin tightening with liposuction.
In an older patient the skin does not tighten as much and if the fat is removed, it may cause the skin to droop more, leaving the patient with a “turkey gobbler” deformity. The take home message here is that if a patient has excess skin on the neck, they may need facelift or neck lift to obtain a pleasing result. It is very common in my practice for patients to come in for evaluation for neck or chin liposuction only to find out that they actually need a facelift for the proper result. The patient shown below underwent face and neck liposuction along with a facelift for this dramatic result.
The above patient shows the dramatic effects of combined facial and neck liposuction combined with facelift surgery.
Another procedure that can greatly enhance the effects of facial liposuction is a chin implant. Many patients that have excess neck fat or skin also have a recessive chin. By augmenting the chin with an implant the result can be greatly improved. The chin implant is a simple procedure that takes about 20 minutes to perform. It can be placed from the inside of the mouth so no scar is visible. A small micro screw holds the implant in place so the result is permanent, unless the patient wants it changed, which is also a simple procedure. The picture below shows a patient that underwent facial liposuction and simultaneous placement of a chin implant.
The above patient underwent facial and neck liposuction with simultaneous chin implant which really improved the aesthetics.
Liposuction is a powerful tool for rejuvenating the face and neck and is used by itself or in combination with other cosmetic procedures. The recovery for facial liposuction is generally about one week. The patient will wear and elastic facial dressing for the first several days, then at night for the next week.
To find more information about facial or head and neck liposuction, visit www.lovethatface.com.
Joe Niamtu, III DMD
Cosmetic Facial Surgery