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The ability to reduce facial fat and deround or sculpt a face by fat removal is limited to a few procedures. The most common procedures to do so on the face are buccal lipectomies and perioral liposuction. While there are companion procedures and are often done together they affect different parts of the cheeks. A buccal lipectomy removes by direct excision a well encapsulated collection of fat in the upper cheek area right under the cheekbone. This reduces cheek fullness down to the horizontal level of the mouth corners. Perioral liposuction removes by small cannula liposuction the subcutaneous fat layer (perioral mounds) from the level of the mouth down to the jawline. Here are my postoperative instructions for these facial defatting procedures.

1.  Buccal lipectomies and perioral liposuction require no form of immediate after surgery compression garments unlike other forms of fat removal. There is no effective way to compress the middle part of the face after surgery.

2.   Ice or gel packs can be applied to the sides of the face after surgery for the first day/night after surgery. There is no benefit to doing it longer unless it makes your face feel better.

3.   Bruising and swelling are to be expected to increase in the first few days after surgery. It will peak by 2 to 3 days after surgery and then gradually go down thereafter. It will take 2 to 3 months to see the full reduction effect of the fat removal.

4.   Showering and bathing can be done the day after surgery.

5.  Despite the intraoral incisions/sutures, resume normal oral hygiene of brushing, the use of mouth wash and flossing. You will not hurt the healing sutures by doing so.

6.  The sutures used in either a buccal lipectomy (opposite the upper first molar) and/or perioral liposuction (inside the corners of the mouth) do not need to be removed. They are dissolvable and will fall out in their own in a few days to a few weeks after the procedure.

7.  The cheek areas will feel stiff, numb and a bit irregular for awhile after surgery. As healing progresses the cheek tissues will gradually return to a normal feel.

8. You may return to normal physical activities and exercise anytime after surgery. You will not hurt or setback the healing process by so doing.

9. Buccal lipectomies are remarkably painless. The only soreness from perioral liposuction comes from the small incisions inside the corner of the mouth which is aggravated a bit by mouth opening.

10. Drive when you feel comfortable and are off pain medication. This is usually within a day or two after surgery as these procedures do not cause much postoperative discomfort.

Dr. Barry Eppley

Indianapolis, Indiana

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