Procedure and recovery
In the lower face tiny stab incisions (1/16 inch in length) are made in the crease beneath the chin. A tiny 1/8 inch Mercedes tipped cannula is introduced into the subcutaneous fatty layer 1/4 inch below the surface. A “cross hatched” pattern is used to aspirate the subcutaneous fat from the submental pocket. If a “bulge” persists, deep penetration is made beneath the anterior neck muscle to reach the underlying fat. The head is turned to each side respectively and fat is aspirated from along the jaw line, lower face, and mid-mandibular jowls. Separate incisions are made at the base of each earlobe and the cannula is swept in a radial direction across the lower face and in front of the neck. The tip of the cannula may be extended as far as the corners of the lip to soften the lip folds (labiomental or “marionette” folds).
The nasolabial folds may be approached through stab incisions at the nostril base. Dr. Rose, however, is reluctant to remove excess fat from the nasolabial fold because he prefers to use this fat for resuspension over the cheek prominences (mid-face lift). Over time, an extensive removal of fat from the nasolabial folds may also lead to a “gaunt” look in the mid-face as the subcutaneous fatty layer naturally thins with the aging process. In “round” faces, the technique of “buccal fat excision” through an internal oral incision can flatten the submalar area of the cheek and the mid-face.
The micro-liposuction is performed as an outpatient under “twilight” sedation (you are totally unconscious) administered by a Board certified anesthesiologist at our state of the art AAAASF outpatient facility: The Aesthetic Surgery Center. Surgery usually lasts forty minutes to an hour and may be as an independent procedure or may be done in conjunction with other facial rejuvenation surgery (i.e. neck lift, mid-face lift, perioral laser resurfacing, fat injections, etc.).
Micro-liposuction incisions are tiny and heal very imperceptibly. Because of the use of a small caliber cannula, rippling is extremely rare. Over a period of time some degree of collagen reorientation will occur and naturally improve the “acuteness” of the cheek/neck angle. Skin retraction depends on a number of factors including age, texture of the skin, thickness of the muscle, inherent chin/neck angle, etc. Bulky, fat necks may be substantially improved with Micro-liposuction. However, a full neck lift may be necessary to minimize the extra skin laxity.
Recovery is quick. Bruising and swelling will generally last seven to ten days but may be well camouflaged with a turtle neck or high collar. A custom blended makeup can be applied to further disguise postoperative bruising. An elastic neck support is worn intermittently for the first two to three weeks post surgery (may be removed during the day, during work or at social occasions).
