Liposuction: Face

Advances in liposuction techniques over the last 5 to 10 years have allowed surgeons to provide liposuction procedure in a safe manner. One of the milestones was the development of tumescent fluid, which is infiltrated into the fat prior to initiating the actual suctioning. Injection of tumescent fluid has allowed surgeons to minimize blood loss significantly. In general, small volumes of tumescent used in the face and neck region make this an extremely safe procedure. Since facial and neck liposuction are performed while you are awake, there are no risks of anesthesia.

In your childhood, the fat volume increases by increased fat cell multiplication which results in more numbers of fat cells. Following adolescents, fat volumes increase by an increase in the size of the fat cells there. An exception to the rule is a client who is overly obese, termed morbid obesity, in which the fat cells can continue to multiply well into adulthood. When a client undergoes liposuction, the fat cells are literally stripped out leaving fewer fat cells in the body. However, if the client does not watch their diet and does not alter their lifestyle, they may regain their weight but not in the areas that have been liposuctioned.

The fat underlying the skin is actually divided into two separate layers: the superficial deep layer. The superficial layer is more dense and has more septa (fibrous cables which span the fat and give it more rigidity). In contrast, the deep layer contains loose fat with less septal support. Universally, liposuction is performed in the deep layer only. By maintaining a uniform and undisturbed superficial layer, clients are ensured an aesthetic result without any contour abnormalities.

No, fat cells cannot travel to other sites. What has occurred is that the client has not followed their postoperative lifestyle recommendation and started gaining weight. Since the areas liposuctioned have fewer fat cells, when the patient begins to gain weight, they are likely to gain it in other non-liposuctioned areas which have a full number of fat cells.

In the evolution of liposuction, one of the obstacles was blood loss. When liposuction was performed without any infusion of fluids into the tissues, the liposuctioned fluid was noted to be 45 % blood in volume. Today, a solution, termed tumescent solution, has been developed which contains lidocaine and epinephrine, molecules that decrease the pain and constrict the blood vessels, respectively. When this solution is infiltrated prior to suctioning, the estimated blood loss is 1 % of the total suctioned volume.

Over 50 % of the United States residents are overweight. As you become overweight you will first accumulate excess fat and then your skin will stretch to accommodate the increased weight of the fat pockets. You are considered a good candidate for face liposuction if you have gained localized fat deposits in your neck causing compromise of your neckline and neck and making your look older than desirable. Patients who see Our Surgical Team often complain that they don’t like the way they look in photographs.

On the day of surgery you will meet with the surgical staff who will provide your oral sedation. Next, Our Surgical Team will take your photographs and mark areas of neck and face fullness. You will then be taken to the operating room where you will be monitored and rest till you feel goofy. Our Surgical Team will then complete your face liposuction. The endpoint of liposuction is determined by the Our Surgical Team who gauges the aesthetic contour of the area liposuction visually and by feel. Several liposuction cannulas may be used in order to maximize amount of removed fat. The edges of the areas liposuctioned are feathered to allow for smooth contour lines. Finger fracture technique is used to break up any septal attachments from the skin to the muscle/bone which will result in a skin tethering appearance if not released. Finally, compression garments/girdles will be placed over the areas liposuctioned so that you can ensure a smooth and aesthetically pleasing contour.

Clients who are considering neck liposuction should be considered healthy; if they have any medical problems such as HTN, should have these problems be well controlled. In general, plan to be evaluated by your surgeon no later than 2 weeks prior to your desired surgery date so that the Our Surgical Team has time to evaluate your health status.

Since your surgery will require as little as oral sedation, you do not have to take many precautions. You will be able to have a light and early breakfast prior to your surgery and to take all of your regular medications. Even though you will not have general anesthetic medication administered throughout the case, you will remain foggy for a couple of hours and will require a ride to and from the office.

Following jowl and neck liposuction, patients can expect improved neck and jaw contour lines. As your swelling resolves and when you stop wearing your compression band, you will find yourself excited about taking photos again.

Even though general anesthesia is not needed for neck liposuction, Our Surgical Team performs all of his liposuction cases at our in-house office based operating room in order to monitor you and provide you a safe surgical environment.

In general, general anesthesia or intravenous anesthesia is not required for neck and face liposuction. Instead patients are provided an oral cocktail that will relax you but allow you to be in control and breathe on you own the whole time.

Compressive postoperative garment with foam will be customized to your neck. This garment is to be worn to minimize postoperative swelling and to optimize your contour. You are asked to wear this garment when not outdoors, around the clock. You will return to the office on day 7 when your garment will be removed for good. You will feel functional within hours of your procedure but will ask to avoid physical activity for 2 weeks following surgery.

Following a routine neck liposuction, you can expect to return to work 1 week following your procedure. You are encouraged to let the degree of soreness dictate how much you can do; the soreness will subside gradually over 1 to 2 weeks.

a)Minor contour irregularities are not uncommon and have several causes. Patients who posses skin looseness have a higher likelihood of developing contour irregularities or skin looseness.

b) Temporary swelling is infrequent in neck liposuction clients but will resolve over the first few weeks.

c) Incisional scarring at liposuction port sites is usually not a concern. The incision port site in the submental region is well hidden in the neck shadow.

d) Sensory changes are caused by mechanical trauma caused by liposuction cannulas. Universally, all sensation will return over 1 to 3 month period.

Wearing of compression garments is critical to attaining smooth and even result following liposuction. During liposuction, a thin layer of fat cells are retained to provide smooth contour of areas liposuctioned. The deeper liposuctioned layer may have retained fat cells that are free floating and not yet settled into their final resting position. Wearing of compression garments assures even distribution of these fat cells until they become fixed in their final resting position. The neck compression garment is ideally worn for 1 week follow.

Much research has been performed regarding the safety of liposuction surgery. Since neck liposuction is does not involve large volume liposuction, typical concerns of body liposuction such as lidocaine toxicity and fluid volume shifts, are not warranted. Most concerns are anatomical and regard respecting vital structures while liposuctioning. Although there are a number of vital structures, such as the trachea, the thyroid gland, the carotid vessels, preoperative markings of these structures and meticulous technique will avoid injury to these structures.

Tumescent solution is the solution that is infused into areas being treated prior to liposuction. Tumescent solution includes: 1 L lactated ringers, 50 ml of 1 % Lidocaine with epinephrine, and 20ml of 8.4% Bicarbonate solution. The lactated ringers solution is merely the vehicle to deliver the medications and is a solution that mimics human physiological solution. The Lidocaine in the solution allows for numbing of the area prior to aspirating the fat with small caliber cannulas. The epinephrine in the solution allows the vessels in the area to be constricted thus minimizing bleeding. The Bicarbonate solution allows for the Lidocaine to work almost instantaneously.

Micro-etching liposculpture refers to liposuction that is performed with small caliber cannulas as small as 3 mm in diameter which allow the surgeon to liposuction areas of concern with greater finesse. Micro-etching allows for accurate removal of fat in neck areas with minimal fat content. Micro-etching is ideal for the neck and jowls.