Liposuction

Face Engineering Exercises

Non-Surgical Alternative to Facial Liposuction

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An incision of 0.4-0.5 cm in length is done at three points around the ear: near the earlobe, near the upper pole and on the posterior sulcus and also on submental region (Fig. 39.2). Those reference points are placed on the incision line marked for rhytidoplasty. A 3 mm Illouz cannula is introduced and, with the suction machine not connected, back and forth movements are done just below the overlying skin all over the face and neck on one side. The surgeon must fold the skin while he/she does the movements with the cannula with its opening turned toward the depth in

Platysma Surgery
Fig. 39.2. Liposuction procedure beneath the skin and above the platysma. a Through submental incision. b The Illouz cannula is above the platysma and below the skin. c Through incision on mastoid area
Neck Traction Before And After
Fig. 39.3. A 59-year-old patient presenting skin flaccidity with plasty with plication of the platysma laterally combined with very flabby platysma with localized adiposities on the face and lipoplasty neck. a, b, c Before surgery. d, e, f Nine months after rhytido-
Submental Incision Platysmal Plication

Fig. 39.4. A 72-year-old male patient presenting very flabby skin with wrinkles with muscule flaccidity on the face and neck. a, b, c Before surgery. d, e and f One year after rhytido-

plasty with plication of the platysma laterally combined with lipoplasty. The medial borders were not sutured

Fig. 39.4. A 72-year-old male patient presenting very flabby skin with wrinkles with muscule flaccidity on the face and neck. a, b, c Before surgery. d, e and f One year after rhytido-

plasty with plication of the platysma laterally combined with lipoplasty. The medial borders were not sutured order to perform tunnelization all around. If the opening is turned to the deep raw surface skin flap it may damage the subdermal fat layer with its small vessels. The skin may become very thin and there is a risk of necrosis postoperatively. This maneuver is done even when liposuction is not performed, since it is an important step for the next step of the operation, which is a tunnelization procedure.

According to the surgical planning, when a patient presents with localized adiposity, liposuction should be performed, then the machine is turned on and the regions with fat tissue are treated. At the end, the thickness of the skin flap is appropriate with all ana tomical structures which provide normal vascularization avoiding any damage postoperatively.

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