Unsatisfactory Results of Liposuction

Abstract

Joseph P. Hunstad, MD Richard A. D'Amico, MD Luiz S. Toledo, MD Peter A. Vogt, MD Dr. Hunstad: The first patient, a young woman concerned with the fullness of her neck, was treated with liposuction. Photographs show platysma bands and an unnatural, over-corrected appearance of the neck (Figure 1). Dr. D'Amico, would you discuss isolated liposuction of the face and neck? Figure 1 A and B , A 38-year-old woman concerned with the fulness of her neck underwent liposuction in the submental region. Postoperative photographs reveal platysma bands and an irregular contour in the submental area. Dr. D'Amico: Facial fat is a precious resource, and rarely would I remove it. The neck, however, presents a different situation. I believe that judicious and conservative fat removal in the neck can be appropriate. Unfortunately, the postoperative defect seen in this patient is all too common. When performing liposuction, we need to be careful to leave some subcutaneous fat in the neck. If this patient is dissatisfied with the results, I would consider performing a platysma band plication. At a later time, if needed, I would consider a filler procedure-structural-type fat grafting would probably be my first choice. Dr. Hunstad: Dr. Toledo, does liposuction have a place when treating a young patient who is primarily concerned with her neck? Dr. Toledo: If the patient also has a fat face and you remove only the fat in the neck, the patient will end up with a very slim neck that is disproportionate to her face, which seems to be the case here. Therefore, when performing a corrective sling procedure, I use an endoscope, which enables me to pass a Gore-Tex® strand from mastoid to mastoid, passing through the cervicomental angle. If there is excess skin, it should be managed with either superficial liposuction or skin removal. …