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Submental and Jowl Liposuction Workup

  • Author: Arthur W Perry, MD, FACS; Chief Editor: Deepak Narayan, MD, FRCS  more...
 
Updated: May 01, 2015
 

Laboratory Studies

Preoperative laboratory tests include only those generally required for surgery.

  • At a minimum, perform urinalysis to look for bacteria and glucose.
  • Perform a hematocrit.
  • Individualize other laboratory tests for the patient.
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Imaging Studies

No particular imaging tests are required for this procedure. Obtaining good quality preoperative photographs is important for medicolegal reasons.

If underlying pathology is suspected based on the physical examination, then perform appropriate tests (eg, CT, MRI of the neck). Be wary of thyroglossal duct cysts, branchial clefts, thyromegaly, and other cervical pathology.

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Contributor Information and Disclosures
Author

Arthur W Perry, MD, FACS Adjunct Associate Professor of Surgery, Columbia University College of Physicians and Surgeons; Clinical Associate Professor, Rutgers Robert Wood Johnson Medical School; Private Practice

Arthur W Perry, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Aesthetic Plastic Surgery, New Jersey Society of Plastic Surgeons, American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Alan Matarasso, MD, FACS PC, Clinical Professor of Plastic Surgery, Albert Einstein College of Medicine; Immed Past President of New York Regional Society of Plastic and Reconstructive Surgery

Alan Matarasso, MD, FACS is a member of the following medical societies: American Society of Plastic Surgeons, American College of Surgeons, American Medical Association, International College of Surgeons US Section, New York Academy of Medicine, New York County Medical Society, Pan America Medical Association of Central Florida, Pan-Pacific Surgical Association

Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center

Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Plastic Surgery Research Council, Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Indian Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Gregory Gary Caputy, MD, PhD, FICS Chief Surgeon, Aesthetica

Gregory Gary Caputy, MD, PhD, FICS is a member of the following medical societies: Wound Healing Society, American Society for Laser Medicine and Surgery, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association

Disclosure: Receive salary from Advantage Wound Care for employment. for: On the speaker's bureau for Smith and Nephew for Santyl Ointment.

References
  1. Illouz YG. The origins of lipolysis. Hetter GP, ed. Lipoplasty: The Theory and Practice of Blunt Suction Lipectomy. New York: Lippincott Williams & Wilkins; 1984. 25.

  2. Hetter GP. Lipoplasty of the face and neck. Lipoplasty: The Theory and Practice of Blunt Suction Lipectomy. New York: Lippincott Williams & Wilkins; 1984. 249.

  3. Stebbins WG, Hanke CW. Rejuvenation of the neck with liposuction and ancillary techniques. Dermatol Ther. 2011 Jan-Feb. 24(1):28-40. [Medline].

  4. Collawn SS. Skin tightening with fractional lasers, radiofrequency, Smartlipo. Ann Plast Surg. 2010 May. 64(5):526-9. [Medline].

  5. Sun Y, Wu SF, Yan S, Shi HY, Chen D, Chen Y. Laser lipolysis used to treat localized adiposis: a preliminary report on experience with Asian patients. Aesthetic Plast Surg. 2009 Sep. 33(5):701-5. [Medline].

  6. Goldman A. Submental Nd:Yag laser-assisted liposuction. Lasers Surg Med. 2006 Mar. 38(3):181-4. [Medline].

  7. Fattahi T. Submental liposuction versus formal cervicoplasty: which one to choose?. J Oral Maxillofac Surg. 2012 Dec. 70(12):2854-8. [Medline].

  8. Gryskiewicz JM. Submental suction-assisted lipectomy without platysmaplasty: pushing the (skin) envelope to avoid a face lift for unsuitable candidates. Plast Reconstr Surg. 2003 Oct. 112(5):1393-405; discussion 1406-7. [Medline].

  9. Rohrich RJ, Pessa JE. The subplatysmal supramylohyoid fat. Plast Reconstr Surg. 2010 Aug. 126(2):589-95. [Medline].

  10. Ramírez OM. Advanced considerations determining procedure selection in cervicoplasty. Part one: anatomy and aesthetics. Clin Plast Surg. 2008 Oct. 35(4):679-90, viii. [Medline].

  11. Rzany B, Griffiths T, Walker P, et al. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study. Br J Dermatol. 2014 Feb. 170(2):445-53. [Medline]. [Full Text].

  12. Ascher B, Hoffmann K, Walker P, et al. Efficacy, patient-reported outcomes and safety profile of ATX-101 (deoxycholic acid), an injectable drug for the reduction of unwanted submental fat: results from a phase III, randomized, placebo-controlled study. J Eur Acad Dermatol Venereol. 2014 Dec. 28(12):1707-15. [Medline]. [Full Text].

  13. Brooks M. FDA Clears Deoxycholic Acid (Kybella) for Double Chins. Medscape Medical News. Apr 29 2015. [Full Text].

  14. Rachel JD, Lack EB, Larson B. Incidence of complications and early recurrence in 29 patients after facial rejuvenation with barbed suture lifting. Dermatol Surg. 2010 Mar. 36(3):348-54. [Medline].

  15. Renaut A, Orlin W, Ammar A, Pogrel MA. Distribution of submental fat in relationship to the platysma muscle. Oral Surg Oral Med Oral Pathol. 1994 May. 77(5):442-5. [Medline].

  16. Becker H. Subdermal liposuction to enhance skin contraction: a preliminary report. Ann Plast Surg. 1992 May. 28(5):479-84. [Medline].

  17. Hughes CE, Chang KN, Kenkel JM. Lipoplasty complications. Aesthetic Surg. 2005. 25:57-65.

  18. Kamer FM, Minoli JJ. Postoperative platysmal band deformity. A pitfall of submental liposuction. Arch Otolaryngol Head Neck Surg. 1993 Feb. 119(2):193-6. [Medline].

  19. Moreno A, Bell WH, You ZH. Esthetic contour analysis of the submental cervical region: a study based on ideal subjects and surgical patients. J Oral Maxillofac Surg. 1994 Jul. 52(7):704-13; discussion 713-4. [Medline].

  20. Newman J, Dolsky RL, Mai ST. Submental liposuction extraction with hard chin augmentation. Arch Otolaryngol. 1984 Jul. 110(7):454-7. [Medline].

  21. Rohrich RJ, Rios JL, Smith PD, Gutowski KA. Neck rejuvenation revisited. Plast Reconstr Surg. 2006 Oct. 118(5):1251-63. [Medline].

  22. Rubin JP, Xie Z, Davidson C, Rosow CE, Chang Y, May JW Jr. Rapid absorption of tumescent lidocaine above the clavicles: a prospective clinical study. Plast Reconstr Surg. 2005 May. 115(6):1744-51. [Medline].

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Patient aged 35 years. Left – Preoperative. Right - 4 months postoperative, liposuction of 25 mL from submental area and jowls with chin implant on right.
Patient aged 36 years. Left – Preoperative. Right - 4 months postoperative, liposuction of 150 mL from submental area and jowls.
Woman aged 45 years. Left – Preoperative. Right – Postoperative, liposuction of neck and jowls and excision of thyroglossal duct cyst.
Woman aged 58 years. Left – Preoperative. Right - 5 months postoperative, liposuction of 100 mL of fat from neck.
This 50-year-old woman underwent liposuction of the submental and jowl areas, as well as the pretragal zones. 200 cc was suctioned. The photos on the right were only 3 weeks postoperative. Additional skin tightening and resolution of swelling is expected.
 
 
 
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