Facial Liposuction, Submental Liposuction & Facial Fat Removal Surgery

What is Facial Liposuction?
Are You A Candidate For Facial Liposuction?
What To Expect At Your Consultation Preparing For Your Surgery
How A Facial Liposuction Procedure Is Performed
The Road To Recovery
Risks & Complications Of Facial Liposuction
The Least You Need To Know
Related Links
References
Frequently Asked Questions About Facial Liposuction
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What is Facial Liposuction?
Facial liposuction, Sub-mentum or sub-mental liposuction and even technically, facial suction lipectomy, is the removal of fat from under the chin from either an intra oral incision or and extra-oral (intradermal) incision under the chin. Or from an incision below the jaw or at the jaw angle to remove jawline fat. This procedure can significantly reduce the appearance of excess facial fat causing an overweight or heavy appearance, a nonexistent chin or a large nose even. Sometimes these complaints are called a double-chin or jowls. This is often a result of aging, obesity, or heredity.

Some patients even request or may benefit from both sub-mentum liposuction and a chin implant to complete the look. The removal of this excess fat pocket can significantly define a lower facial structure. Some patients may even have their jowl fat removed along their jawline.

If it is the lower cheek fat you desire to remove such as if you believe you have chipmunk cheeks or a very round face that seems to be there to stay -- perhaps you'd like buccal fat extraction.

Are You A Candidate For Facial Liposuction?
First and foremost, an individual must be in good health, not have any active diseases or pre-existing medical conditions and must have realistic expectations of the outcome of their surgery. Communication is crucial in reaching one's goals. You must be able to voice your desires to your surgeon if he/she is to understand what your desired results are. Discuss you goals with your surgeon so that you may reach an understanding with what can realistically be achieved.

You must be mentally and emotionally stable to undergo an cosmetic procedure. No surgeon would agree to work on a mentally unstable person. Surgery is not getting a cavity filled. This is an operation which requires patience and stability in dealing with the healing period. There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue. Please consider this before committing to a procedure.

If you find that your under chin area and/or jaw line retains excess pockets of fat or a pudge and you do not appreciate this look, you may wish to consider this procedure. It is not a rather invasive procedure but it will cause discomfort and swelling and you will have to take it easy for a proper result so consider all of the above before deciding if this may be a viable option.

What To Expect At Your Consultation
After checking a few surgeons' backgrounds and credentials, you will make appointments for consultations. You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc. -- this is very important. Visit the Medication & Supplements List for more information.

You will discuss your complaints and concerns and discuss the various techniques, the amount that can and should be removed, etc. Your surgeon will explain the technique and incision placements or methods that may be most appropriate for you and should discuss the risks associated with facial liposuction with you, as well.

You will also discuss the available anesthesia that will be used for your procedure. Most facial liposuction procedures are performed under Light Sleep Sedation, Twilight or regional -- sometimes even local with oral sedation. However, some surgeons may use General Sedation. Either way, discuss this beforehand as many people are not aware of the risks of Anesthesia. If you do go under General, ascertain that the anesthesiologist is certified. Please read the All About Anesthesia Page -- the risks regarding anesthesia should be considered for a fully informed choice.

You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead. You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs and perhaps a box or directions for gaining a bottle of Arnica montana. Perhaps you will be instructed to obtain Bromelain or other types of remedies, although many surgeons would rather have you not take ANYTHING other than your prescription medications, please do not go against your surgeon's wishes.
these products? Remember, always ask your doctor before taking any of these products.

If you would like more information on Consultations or a list of questions to ask your surgeon please visit the Consultation Help Page

Preparing For Your Surgery
You should be given a pre-operative information packet that explains everything you should do and know before your surgery date. The packet should include a list of all the medications you should not take starting usually at 2 weeks before your surgery. These medications will include, but are not limited to, aspirin containing products, stimulants, seratonin supplements, etc. Would you like to view a typical Medication & Supplements List? We have a printer-friendly version as well. Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities.

It is quite possible that you will have preliminary blood work performed. This is normally an extra out-of-pocket expense that the patient must participate in to check your white and red blood cell count (complete blood count, CBC) which may ultimately alert your surgeon to disease or disorders beforehand. If you are a female they may take an extra vial for a pregnancy test. Some surgeons ask that you have physical. This can be yet another out of pocket expense so ask at your consultation what will be needed when you are quoted a price.

So many things to do... so little time. Surgery will be here before you know it so visit the Preparing For Surgery page and relax. This section contains, printer-friendly pre-op lists, tips and advice as well as things you must do to prepare for your big day.

How A Facial Liposuction Procedure Is Performed
A facial liposuction procedure normally takes about 45 minutes to an hour to perform. First, you will be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date. If you had been given an oral sedative or valium prior you usually could care less what they are sticking in you. They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway should the need arise. If you haven't been given a sedative, it is more stressful for some patients. Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time. It's the initial placement of the IV that may sting a bit. After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein. This is called a catheter, which is taped to your skin so it is not knocked out and is ready to be used as a sort of entryway for anything the surgical team deems suitable for your body. This is usually done before you get into the actual O.R. -- by a nurse -- and you have a saline bag hooked up to you. The medications will usually be given with a drip system with this saline. As I said, the saline will keep you hydrated both during and post-operatively.

Some people get their IV placed in the crook of the elbow, some the hand. I dislike the hand ones as it's a nasty place for a bruise to be, at least with the arm you can hide it -- it all depends upon your veins though. So if your veins are not very prominent this can be a problem. You are then brought to the O.R. if you aren't on the table yet.

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body. The effects of the anesthesia are felt soon after injection or opening the stopper -- a few seconds in fact. It feels like heat going into you veins then creeping up your arm -- then it jumps from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.

If you have chosen local with oral sedation you may have been given a valium or comparable to calm you and are given either regional or local injections of lidocaine and epinephrine and the surgical team waits until you are properly numb.

Your surgeon will make an incision about 2 to 4 cm long in the mandible (jaw) angle, under the chin or between the gums and the bottom of the inner lower lip where it joins the gums of the mandible, starting above the second upper molar towards the back of the mouth.

With the external incision the cannula (a titanium wand attached to a vacuum with a reservoir for the removed fat) will be inserted into the incision and the tip is moved back and forth to loosen the fat. The suction will remove the loosened fat cells and your surgeon will continually pinch your skin between his thumb and forefinger to determine the amount to me removed.

With the intra-oral incision, care must be taken as to not press the cannula directly against the under part of the skin. This can remove too much superficial fat and create dents or lumps. It can also mottle the skin. Some surgeons prefer the external incisions although with proper skill the intra oral technique can produce a wonderful result.

The surgical team then performs a sponge and instrument count and your surgeon then closes your incisions with, more than likely, a non-dissolvable type suture. You may have an antibiotic-soaked piece of gauze placed between your lower lip and your gums and a pressure dressing placed around your head such as you would see in a face lift patient. If you are not familiar with this look it involves wrapping a dressing around the top of your head to underneath your chin, sometimes slightly over your ears. Of course there may be differences in surgical technique depending upon the preference of your surgeon.

You are then wakened gently and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours. Your neck and chin may feel tight and quite tender as the anesthesia wears off. You may even feel emotional or upset -- this will depend upon your body's reaction to anesthesia. You may also experience rigors or shivering. This may feel uncontrollable and is usually from the medications -- more than likely epinephrine that is used as a vasoconstrictor. The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable.

Some patients feel nothing different although if you have had General you may feel a little sick -- hopefully your surgeon gave you something to lessen this. Your prescribed medication should alleviate this pain and discomfort. However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately. You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home.

The Road To Recovery
You may be groggy from the anesthetic and or oral medications and probably won't remember much of the first day or two. You will have to take it easy and sleep on two pillows to keep your head elevated for 7 to 14 days, or however long your surgeon suggests. When you wake up you will notice that your neck and lower face will look even more swollen in the first 3 days. But, as the days go on the swelling will dissipate. There may be bruising, but this will go away, as well. So make a mental note of this or you may be shocked into a depression. Bruising and swelling are a normal occurrence in most surgeries.

You will more than likely experience some discomfort for several weeks -- if you had intraoral incisions your diet may be restricted. You should ascertain all fresh fruits and vegetables have been washed, no raw fish (sushi), very rare meat or other types of foods that may contain high amounts of bacteria. Eating foods such as this may increase your risk of infection due to the incisions being in the mouth. You may be instructed to rinse with Listerine several times a day. DO NOT PICK or tongue your incisions or sutures!

Although any discomfort should be alleviated by your prescribed pain medication if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon immediately! Take your temperature regularly. An elevated temperature could mean an infection. Take those antibiotics on time. Also, don't forget if you are a female taking birth control pills that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well.

Your sutures will more than likely be taken out by your surgeon any time between 5 to 10 days postoperatively. Even though you may feel better, you must take it easy for the first 3 weeks. Be careful not to bend over or lift heavy objects. And be careful not to raise the blood pressure for at least 3 weeks as this could cause internal bleeding at your treatment area. Your blood vessels dilate to allow increased blood flow when you raise your heart rate. This may cause problems at internal wound sites. Do not participate in contact sports for at least 6 to 8 weeks -- although ask your surgeon what he recommends specifically.

Your swelling will subside within a few weeks, defining even more temporary change in your smile if you have had an intraoral approach, odd sensations of hollowness under your chin, tingling, the sporadic sharp pain, or pulling, burning, and cold sensations. These usually subside within the first few weeks.

Risks & Complications Of facial Liposuction
Unfortunately, all surgery has risks and complications. With facial liposuction, these include allergic reaction to the anesthetic used and infection. There could be asymmetry, general dissatisfaction, hematoma or seroma, lumpiness, and/or mottling.

Numbness is possible, it usually subsides within the first few weeks but it may become a permanent issue. Puckering of the skin may occur and deeper than desired depressions may result. Excess scar tissue and lumps are possible as well.

The Least You Need To Know

What: facial, submental, submentum liposuction - even facial suction lipectomy
Why: usually to aid in defining or removing overly fatty pockets under the chin, along the jawline and on the neck.
When: from late teens to whatever age.
Who: A skilled plastic surgeon with a good background and experience in performing this operation.
Where: Accredited Surgical Suite or hospital
Risks: Please see above
incisions/scars: non-visible, intra-oral incisions or external inconspicuous incisions
Anesthesia: Light Sleep IV Sedation or General IV -- possibly oral sedation with regional/local. Read All About Anesthesia
Duration: 45 min -1 hour, depending upon extent of work to be done.
Pain Factor: mild to moderate, pain meds should alleviate any discomfort. If not, call your surgeon immediately.
Swelling: Mild to moderate -- depending upon individual's health, and habits such as smoking, protein consumption, iron level, etc.
Bruising: mild - depending upon individual;
Post-operative instructions: Have someone there to help care for you during your recovery, keep elevated - even when sleeping. A recliner works best.
1st Post-op visit: usually to remove sutures at 5 to 10 days post, sometimes earlier.
2nd Post-op visit: check up usually at 3 weeks for exercise/activity release
Return to work: usually within 3 to 5 days -- but depends upon type of wok. Sedentary (desk job) with little or no amount of talking. If your job requires high impact activity you may need more time off, please ask your surgeon.
Activity: No exercise until at least 3 weeks post-operative. Be careful not to raise your blood pressure for several weeks, you don't want to inhibit proper healing.. Check with your surgeon.
Sun exposure: do not expose incisions to UV light as this can cause damage to the newly forming collagen (scar tissue), and hyper- or hypo-pigment. When in sunlight, wear at least a SPF30.
End result: usually can be seen within 1 to 2 months
Loss of Sensitivity: It is possible to lose sensation along the incision lines, on the under chin area and jaw line. Long term or permanent loss of sensitivity is possible.
Other complications: Possible eyebrow and eyelash loss from medications. Possible asymmetry as well.
Longevity: semi-permanent or until you gain weight or age-related fat pockets return
Special Notes: Disclose all your medical background. If you are a smoker, if you are taking medications, or if you have any other medical concerns. Be realistic in your expectations. No plastic surgeon can perform miracles, he or she can only try and improve upon what you have beforehand.
The average prices for: facial liposuction may be from 1 area: $1,500 - $3,800US and depends upon the surgeon and region as well as if the surgeon has his or her own surgical suite. With procedures performed in a hospital or under General with a certified anesthesiologist - prices are usually be higher.

References
Merriam-Webster Medical Dictionary

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