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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
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.
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
Are You A Candidate For
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
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.
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.
also discuss your pre-operative instructions and speak about the
recovery period instructions and what to expect in the months ahead.
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
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
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
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.
Facial Liposuction Procedure Is
liposuction procedure normally takes about 45 minutes to an hour to perform.
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.
I said, the saline will keep you hydrated both during and
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.
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.
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.
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
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.
more than likely experience some discomfort for several weeks -- if you had intraoral incisions your diet may be restricted.
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!
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.
will more than likely be taken out by your surgeon any time between 5 to
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.
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.
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.
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.
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
The Least You Need To Know
facial, submental, submentum liposuction - even facial suction
to aid in defining or removing overly fatty pockets under the chin, along
the jawline and on the neck.
from late teens to
A skilled plastic
surgeon with a good background and experience in performing this
Accredited Surgical Suite
intra-oral incisions or external inconspicuous incisions
Light Sleep IV
Sedation or General IV -- possibly oral sedation with regional/local.
Read All About Anesthesia
45 min -1 hour, depending upon extent of work to be done.
Factor: mild to moderate,
pain meds should alleviate any discomfort. If not, call your surgeon
Mild to moderate --
depending upon individual's health, and habits such as smoking,
protein consumption, iron level, etc.
mild - depending upon
someone there to help care for you during your recovery, keep
elevated - even when sleeping. A recliner works best.
usually to remove sutures at 5 to 10 days post, sometimes
Post-op visit: check up usually at 3 weeks for exercise/activity
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.
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.
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.
result: usually can be seen within
1 to 2 months
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
eyebrow and eyelash loss from medications. Possible asymmetry as
semi-permanent or until you gain weight or age-related fat
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
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.
of the Face & Neck - Emedicine