Liposuction is a very effective method of fat removal. While it can be used in almost any location of the body where there is fat, it does have limitations. And when applied to certain fat areas, it may even have the opposite effect of an undesired result.
The face is one such area where the concept of liposuction is limited. While the face does have fat below the skin, it is not easily removed like that in the trunk or extremities. Facial fat is more fibrous and has branches of the facial nerve lying deep to it. There are few very discrete collections which can easily be removed with the exception of the buccal fat pad and some of its numerous extensions.
Plastic surgeons frequently advertise and perform neck liposuction. And while the neck is part of the face, most patients do not think of the neck when they envision the concept of facial liposuction.
When you combine what is contained in the buccal space with the subcutaneous tissues in the neck, these are the only two commonly recognized facial areas where contouring can be done through fat removal. The neck can be liposuctioned while the buccal fat pad can be directly extracted through a small open incision. Removal of any other facial fat areas is largely restricted to the perioral mound area, the subcutaneous fat area along the sides of the mouth out into the lateral face.
When liposuction first became widely used in the 1980s and 90s, facial liposuction was both advocated and practiced. It was used to try and reduce facial fullness in the lateral face and even reduce the prominent mound of tissue that develops above the nasolabial fold with aging. It was proven to be ineffective and has since become largely abandoned as a treatment for facial fullness.
For those seeking to reduce their ‘fat’ face or to deround their facial appearance, liposuction alone is not the complete answer. It simply can not do what can be done for the circumference of the thigh or the waistline. One cannot treat the face in an overall manner with liposuction.
Improving the shape of a very full and round face does include some fat removal which is accessible, the buccal fat pad, the perioral mounds and neck fat. If a full neck is all that bothers someone, then liposuction alone is a good treatment. But for more total facial sculpting and definition creation, it must be combined with other procedures that bring out or highlight facial prominences such as the chin, cheeks, or jaw angles. Using implants in these facial convexity areas, in conjunction with facial and neck defatting, can help bring shape to an otherwise amorphous face.
Dr. Barry Eppley
Indianapolis, Indiana