Submental and Jowl Liposuction

• Aesthetic surgery has now become commonplace with thousands of individuals going under the knife seeking a more pleasing appearance. Of the various aesthetic surgical procedures, liposuction of the face and jowls finds a special place due to the dramatic change in appearance following this short, relatively low-risk and inexpensive procedure compared to the much higher costs and risks associated with a with a facelift.
• About 25% of liposuction procedures are focused on segmental area and jowls making this one of the most common aesthetic procedures of the face and neck. It may possibly done alone or in conjunction with a facelift or platysmaplasty.

A little history about submental jowl liposuction

• Liposuction was originally described in the late 1970s. Over the years, it has developed from a basic scientific experiment to a work of art. It is used regularly for cosmetic rejuvenation of the submental area, neck and jowl with great efficacy, accuracy and unparalleled aesthetic appeal. With each passing decade, there have been new advancements made, resulting in smaller cannulas, tiny incisions, and fewer side effects.  
• With the introduction of newer devices and techniques such as subcutaneous infiltration with tumescent fluid, laser-assisted liposuction, fractional lasers, radiofrequency, infrared radiation, and high-energy focused ultrasound (i.e. Ulthera), these procedures are now acceptable for  broader age range.. Many of these devices and techniques are still being studied for efficacy and safety, thus requiring due discretion on the part of both the surgeon and patient.

Defining the submental jowl problem

 The problem consists of submental fat, jowl fat, and loss of definition of the mandible (jawline).

• Extra submental fat is often seen in heavy individuals and often presents as a “double chin”.  Normal-weighted individuals may possibly also have visible fat in the region, particularly with the loss of elasticity associated with aging.  It may possibly also just be genetic. 
• Jowls look like the accumulation of fat on the lower cheek overlying the jaw bone and are more commonly and prominently found in people over 50 years of age. They are undeniable signs of aging and are accentuated by loss of collagen and loss of contour of the mandible.
• In adds to to removing fat, submental liposuction causes contraction of the skin.  This helps to regain the tightness and smoothness of youthful skin.

Who undergoes Submental and Jowl liposuction?

•  Women, arguably being more concerned with their looks, are more likely to undergo submental or jowl liposuction, especially those beyond 40 years of age and with a heavy face. That said, this procedure is done in patients from anywhere between 18 to 80 years of age and includes a fair share of men.
• Submental and jowl liposuction is considered a viable, safer and less expensive alternative to a facelift. It is appropriate for patients with submental fat or jowls seeking aesthetic improvement or for those who are not suitable for facelift surgery due to, for example, an ongoing smoking habit, diabetes or significant medical problems.
• Patients requiring speedy recovery and those just not ready for a big procedure are good candidates.

What does submental jowl liposuction involve?

• Liposuction of the jowls and submental area involves removal of fat in the pre-platysmal plane, avoiding the mandibular nerve which is just deep to the platysma. Other structures that need to be avoided are the external and anterior jugular veins, facial artery and marginal mandibular nerve.
• Deep penetration and injury are more common in re-operative procedures due to anatomic changes and scar tissue formation.  Liposuction in areas of scar tissue requires greater force and is therefore more likely to cause injury.

Contraindications for Submental and Jowl Suction

• There are both medical contraindications and aesthetic contraindications.
• Medical contraindications are relative and include illnesses that may possibly increase the risk of complications such as cardiovascular or pulmonary disease or those with a previous history of neck surgery. 
• Aesthetic contraindications include poor skin elasticity and platysmal banding. Sub-platysmal fat is a primary cause of patient dissatisfaction and can be removed only with direct excision. Large sub-mental glands are also problematic—some surgeons do reduce or remove these glands.