eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Cosmetic Surgery

Liposuction of the Face and Neck: Follow-up

Author: Manoj T Abraham, MD, FACS, Clinical Assistant Professor, Division of Facial Plastic & Reconstructive Surgery, New York Medical College,New York Eye & Ear Infirmary; Private Practice, Facial Plastic, Reconstructive & Laser Surgery PLLC
Coauthor(s): Thomas Romo III, MD, FACS, Chief, Clinical Instructor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, New York Eye and Ear Infirmary
Contributor Information and Disclosures

Updated: Oct 6, 2008

Outcome and Prognosis

When the techniques described in this article are used, the vast majority of patients undergoing liposuction of the face and neck are happy with the outcome of surgery. In his series of 47 consecutive patients, Adamson reported no patients who were dissatisfied with their liposuction result. Other studies reported in the literature mirror this success rate. This favorable result is in a large part predicated by ensuring that patients understand the goals and limitations of cervicofacial liposuction and have realistic expectations of surgery.

Future and Controversies

The practice of cervicofacial liposuction is continually evolving, and many authors have proposed modifications to the techniques described in this article. Flynn and others advocate tumescent liposuction, a technique in which a large volume of normal saline mixed with dilute lidocaine and epinephrine is infiltrated into the subcutaneous plane with a blunt-tipped injector prior to commencing liposuction. These authors believe that ballooning of the subcutaneous tissue and fat aids in tunneling within the right plane, encourages hemostasis, and helps harvest fat in a less traumatic manner. However, tumescent liposuction does result in significant distortion of the anatomy, making it more difficult to judge the degree of fat removal needed to achieve the desired symmetric facial profile.

Adamson notes that Newman and others have recommended subplatysmal liposuctioning to better define the cervicomental angle and buck jowl liposuctioning via an intraoral or sublabial approach to excise ptotic fat in the buccal space.3 The authors' opinion is that the risk of injury to vascular structures and the marginal mandibular nerve is significantly increased by performing liposuction deep to the platysma. Aggressive suctioning in this area may also lead to depressions and uneven contour of the platysma. Care must be taken if liposuctioning via an intraoral approach to avoid injury to terminal branches of the buccal nerve and to prevent salivary contamination of the entire dissection plane predisposing to infection.

Gross and others have recently advocated liposhaving as a superior alternative to liposuction. With liposhaving, commercially available soft tissue shavers (often employed in endoscopic surgery) are used instead of the liposuction cannula to sharply amputate fat deposits sucked into the shaver with minimal suction.4 Great care must be taken to activate the blade only when the shaver is in continuous motion and in the appropriate location, in order to avoid overresecting fat and macerating skin edges. In the right hands, liposhaving is quicker and less labor-intensive then traditional liposuction. However, the safety of this technique with respect to damage to surrounding soft tissue and neurovascular structures must be proved unequivocally before it can be recommended for general use.

For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article Liposuction.

 


More on Liposuction of the Face and Neck

Overview: Liposuction of the Face and Neck
Workup: Liposuction of the Face and Neck
Treatment: Liposuction of the Face and Neck
Follow-up: Liposuction of the Face and Neck
Multimedia: Liposuction of the Face and Neck
References
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References

  1. Teimourian S. Suction lipectomy of the face and neck. Facial Plast Surg. Fall 1986;4(1):35-43. [Medline].

  2. Converse JM. Reconstructive Plastic Surgery. New York, NY: WB Saunders Co; 1977:1869-75.

  3. Adamson PA, Cormier R, Tropper GJ, et al. Cervicofacial liposuction: results and controversies. J Otolaryngol. Aug 1990;19(4):267-73. [Medline].

  4. Gross CW, Becker DG, Lindsey WH, et al. The soft-tissue shaving procedure for removal of adipose tissue. A new, less traumatic approach than liposuction. Arch Otolaryngol Head Neck Surg. Oct 1995;121(10):1117-20. [Medline].

  5. Aguilar EA 3rd. Cervicofacial liposurgery. In: Bailey BJ, Tardy ME Jr., eds. Head & Neck Surgery—Otolaryngology. New York, NY: Lippincott, Raven; 1998:2799-2809.

  6. Becker DG, Cook TA, Wang TD, et al. A 3-year multi-institutional experience with the liposhaver. Arch Facial Plast Surg. Jul-Sep 1999;1(3):171-6. [Medline].

  7. Butterwick KJ. Enhancement of the results of neck liposuction with the FAMI technique. J Drugs Dermatol. Oct 2003;2(5):487-93. [Medline].

  8. Dedo DD. The aging neck. In: Bailey BJ, Tardy ME Jr., eds. Head & Neck Surgery—Otolaryngology. New York, NY: Lippencott Raven; 1998:2717-32.

  9. Donofrio LM. Fat rebalancing: the new "Facelift". Skin Therapy Lett. Nov 2002;7(9):7-9. [Medline].

  10. Farrior EH, Park SS. Suction assisted lipocontouring. In: Cummings CW, Krause CJ, Thomas JR, eds. Otolaryngology, Head and Neck Surgery. New York, NY: Mosby; 1998:709-19.

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

  12. Jasin ME. Submentoplasty as an isolated rejuvenative procedure for the neck. Arch Facial Plast Surg. Mar-Apr 2003;5(2):180-3. [Medline].

  13. Markman B. Anatomy and physiology of adipose tissue. Clin Plast Surg. Apr 1989;16(2):235-44. [Medline].

  14. Sattler G, Sommer B. Liporecycling: a technique for facial rejuvenation and body contouring. Dermatol Surg. Dec 2000;26(12):1140-4. [Medline].

  15. Schaeffer BT. Endoscopic liposhaving for neck recontouring. Arch Facial Plast Surg. Oct-Dec 2000;2(4):264-8. [Medline].

  16. Sclafani AP, Kwak E. Alternative management of the aging jawline and neck. Facial Plast Surg. Feb 2005;21(1):47-54. [Medline].

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Further Reading

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Keywords

liposuction, cosmetic surgery, liposuction of the face and neck, cervicofacial liposuction, liposhaving, lipocontouring, liposurgery, cervicofacial, cervical, cosmetic, aesthetic, aging, mandible contour, cervicomental angle, rhytidectomy, malar implants, chin implants, genioplasty, submental liposuction, ptosis, facial support structures, malar fat pad, buccal fat pad, skin elasticity, wrinkles, sagging of facial skin, tissue laxity, jowls, wattles, turkey gobbler, cervicofacial support structures, cosmetic deformity, facial plastic surgery, hyoid bone, retruded mandible, prognathic mandible, parotid gland, submandibular gland, platysma, liposuction of the face and neck, liposuction of the face, liposuction of the neck, cosmetic surgery of the face

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Contributor Information and Disclosures

Author

Manoj T Abraham, MD, FACS, Clinical Assistant Professor, Division of Facial Plastic & Reconstructive Surgery, New York Medical College,New York Eye & Ear Infirmary; Private Practice, Facial Plastic, Reconstructive & Laser Surgery PLLC
Manoj T Abraham, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Physicians of Indian Origin, American College of Surgeons, American Medical Association, American Rhinologic Society, American Society for Cell Biology, California Medical Association, Medical Society of the State of New York, New York Academy of Medicine, New York County Medical Society, Sigma Xi, and Triological Society
Disclosure: Nothing to disclose.

Coauthor(s)

Thomas Romo III, MD, FACS, Chief, Clinical Instructor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, New York Eye and Ear Infirmary
Thomas Romo III, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and American Rhinologic Society
Disclosure: Nothing to disclose.

Medical Editor

J David Kriet, MD, FACS, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Director of Facial Plastic and Reconstructive Surgery, University of Kansas School of Medicine
J David Kriet, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, AO Foundation, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Keith A LaFerriere, MD, Clinical Professor, Fellowship Director, Department of Surgery, Division of Otolaryngology, University of Missouri at Columbia
Keith A LaFerriere, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

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