Volumetric Maneuvers Below the Jawline Fine Tunneling and Superficial Liposuction

Face Engineering Exercises

Non-Surgical Alternative to Facial Liposuction

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In the late 30s or early 40s with the beginning of the early stage of jowling, a wide soft-tissue undermining is not yet required. A detachment in the deep subcutaneous layer limited to the midcheeck and the lateral third of the neck combined with a submandibular and submental superficial liposuction [9] will provide a regular clean jawline with flattening down of the jowls (Figs. 44.1).

The surgery is performed under general anesthesia with intravenous Propofol, the headrest allowing a smooth turning of the head to the left and the right side. The tumescence is performed with the following liquid: 250 ml Ringer's lactate, 10 ml 1% Xylocaine, 0.5 mg adrenaline, 60-80 ml each side infiltrated to the cheek/submandibular/submental area before liposuction (Fig. 44.2).

The periauricular incision and partial undermining and infiltration of the cheek-neck area proceeds with the introduction of a 2 mm liposuction cannula for in the submental and submandibular region (Fig. 44.3). The fine tunneling of the neck below the jawline and of the submental area has a contouring effect in addition to the required reduction of volume (Fig. 44.4).

Vermilion Lip Procedure
  1. 44.1. A 42-year-old patient with unpleasant lower face jowling compared with a juvenile upper face. Result 3 weeks after face-neck contouring from a periauricular access up to the midcheek and the lateral third of the neck with undermining in the subcutaneous layer combined with a superficial liposuction of the submandibular and submental area. A perioral microfat-grafting including the nasolabial, upper lip, angle of the mouth and vermilion area has completed the facial rejuvenation
  2. 44.1. A 42-year-old patient with unpleasant lower face jowling compared with a juvenile upper face. Result 3 weeks after face-neck contouring from a periauricular access up to the midcheek and the lateral third of the neck with undermining in the subcutaneous layer combined with a superficial liposuction of the submandibular and submental area. A perioral microfat-grafting including the nasolabial, upper lip, angle of the mouth and vermilion area has completed the facial rejuvenation
Submental Area
Fig. 44.3. The periauricular incision and partial undermining and infiltration of the cheek-neck area proceeds with the introduction of a 2 mm cannula for liposuction in the submental and submandibular region
Lipo The Jawline
Fig. 44.4. The fine tunneling of the neck below the jawline and of the submental area has a contouring effect in addition to the required reduction of volume

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