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Defatting of the face is very different than the body. Due to the location of vital motor nerves, the more fibrous nature of facial fat and its very discrete locations, facial fatting is much more limited. While it is possible to selectively remove small areas of facial fat, it is not possible to have a more generalized and significant effect.

One such facial area that can be defatted is the perioral mound area. Often confused with the location of the buccal fat pad, this is a small collection of subcutaneous fat overlying the buccinator muscle just to the side of the mouth. It merges into the more inferior jowl fat which is also a subcutaneous fat layer. Patients often do not like the fullness that it creates in this facial area.

The perioral mound area can be treated by liposuction. Entering through a small incision just inside the corner of the mouth the area is easily accessed and treated. The key is that the traditional size liposuction cannula should not be used as it is too big. Even cannulas used for the neck can remove fat too much quickly or leave an irregular contour.

I prefer to perform perioral mound liposuction with a very small size cannula at the diameter of 1 to 1.5mm. The best cannula to use is actually not a liposuction aspiration cannula at all but a fat injection cannula. With just one hole on one side of the end of the cannula, it can be remarkably effective at removing fat from a small area like the perioral mounds with little to no risk of causing surface irregularities. This can be called therefore perioral mound microliposuction.

While the volume of fat extraction from the perioral mounds is small (1 to 3ccs per side) it can have a very visible reductive effect.

Dr. Barry Eppley

Indianapolis, Indiana

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