SUB-MENTAL LIPOSUCTION WITH OR WITHOUT PLICATION
This information describes the simplest approach to the neck which may or may not be appropriate for you. Sometimes this procedure is called a “week-end facelift” because the recovery is short, but I do not like that expression because I think it is mainly about marketing.
With time fatty deposits will often develop underneath the chin. There is extra skin under the chin compared to what used to be present. The skin tends to separate from the jaw line and hang down. The muscles of the neck separate and droop giving what are called “platysmal bands” or a “turkey-gobbler” appearance to the neck. What sub-mental liposuction with plication and facelift have in common is that they both have a small incision under the chin, about one inch, which is not very noticeable. Through this incision liposuction of the neck is performed, the muscles of the neck are brought back together in the mid-line and the skin is re-draped. For a patient whose main problem is fatty tissue and muscle separation, sometimes a facelift can be avoided by performing this neck operation. For patients who have significant excess skin under the chin, this simple operation will not work for them, this skin will have to be removed through a neck lift in order to prevent unnatural re-draping of the skin folds. In some cases, even though a facelift would be optimal in terms of removing extra skin and improving the contour of the neck, sub-mental liposuction and plication will be performed instead. This may be because there is a shorter recovery. This is often a good option in men in whom the scars around the ears are often not as easily hidden.
Sub-mental liposuction and plication takes about an hour and a half whereas a facelift takes about 3 hours. It is an out-patient procedure usually performed in the office under sedation. The time out of work is usually less than a week rather than about 2 weeks and obviously there are no scars around the ears. Complications of sub-mental liposuction and plication include bleeding. There is occasionally a drain behind the ear which will be removed within 2 days after the surgery. The scar might be thicker than what would be hoped. This can be revised at a later date, if necessary. Bruising is normal, swelling is normal, the risk of infection is only 1 in 100. Very rarely a patient could have a crooked smile for a few weeks after surgery, but there is no real risk of permanent nerve damage from this operation.
There could be some minor surface irregularities to the skin during the
healing process, especially if you had significant skin excess, but these almost always resolve over time and certainly are still an improvement from the contour before the procedure was performed. In addition to this, although the neck line will look much better in the first few weeks, it will feel firm to the touch for up to 3 months and this is completely normal. There may also be some temporary numbness of the skin but this will resolve over time.
Smokers heal poorly in terms of infection and wound breakdown and you are advised not to smoke for at least 14 days before and after the surgery.
It is somewhat variable how much the neck skin will shrink after the fatty tissue is removed underneath the skin. This depends on the age and general condition of the skin in terms of sun damage, smoking and genetics. In some patients this is the only operation that they will have while in others it is simply a way of delaying a facelift for a few years.
I hope that this information has not been overwhelming in terms of the possibilities of complications. I have tried to give you as complete information as possible so that you can make an informed decision. Nonetheless, I would like to emphasize that the overwhelming majority of the patients have successful and uncomplicated surgery and are quite pleased with the results.
It would be a pleasure to discuss sub-mental liposuction with you.
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