Some patients even request or may benefit from both sub-mentum liposuction and a chin implant to complete the look , if needed. The removal of this excess fat pocket can significantly define a lower facial structure. Some patients may even have their "jowl" fat removed along their jaw line.  If it is the lower cheek fat you desire to remove such as if you believe you have "chipmunk" cheeks or a very round face that seems to be there to stay - perhaps you'd like buccal fat extraction. 

Are You A Candidate For Facial Liposuction?
First and foremost, an individual must be in good health, not have any active diseases or pre-existing medical conditions and must have realistic expectations of the outcome of their surgery.  Communication is crucial in reaching one's goals. You must be able to voice your desires to your surgeon if he/she is to understand what your desired results are.  Discuss you goals with your surgeon so that you may reach an understanding with what can realistically be achieved.

You must be mentally and emotionally stable to undergo an cosmetic procedure.  This is an operation which requires patience and stability in dealing with the healing period.   There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue.  Please consider this before committing to a procedure.

If you find that your under chin area and/or jawline retains excess pockets of fat or a "pudge" and you do not appreciate this look, you may wish to consider this procedure.  It is not a rather invasive procedure but it will cause discomfort and swelling and you will have to take it easy for a proper result so consider all of the above before deciding if this may be a viable option.

What To Expect At Your Consultation 
After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation.  You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc. - this is very important.  Visit the Medication & Supplements List for more information. 

You will discuss your complaints and concerns and discuss the various techniques, the amount that can and should be removed, etc.  Your surgeon will explain the technique and incision placements or methods that may be most appropriate for you and should discuss the risks associated with facial liposuction with you, as well. 

You will also discuss the available anesthesia that will be used for your procedure.  Most facial liposuction procedures are performed under Light Sleep Sedation, Twilight or regional - sometimes even local with oral sedation.  However, some surgeons may use General Sedation.  Either way, discuss this beforehand as many people are not aware of the risks of Anesthesia.  If you do go under Deep General, ascertain that the anesthesiologist is certified.  Please read the All About Anesthesia Page - the risks regarding anesthesia should be considered for a fully informed choice. 

If you would like more information on Consultations or a list of questions to ask your surgeon please visit the Consultation Help Page.  If you should choose to book or reserve a surgery date you will usually give a deposit to hold your surgery date.  Most times if you cancel a few days beforehand, this amount is non-refundable.  After paying your deposit and scheduling a surgery date, you will also schedule a pre-operative appointment...

Your Preoperative Appointment
This appointment addresses more questions you may not have thought to ask at the initial consultation, such as more surgical details, concerns and even ascertaining that your surgeon is aware of what you desire from your procedure.   Just as your surgeon will make certain that you know what it realistically possible from this procedure.

You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead.  You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs.  Remember, always ask your doctor before taking any of these products. 

Please do not hesitate to address any concerns that you may have during this time and even after your pre-operative appointment.  If you remember something when you get home or the next day or even the day of surgery - don't be afraid to ask. 

Preparing For Your Surgery 
You should be given a pre-operative information packet that explains everything you should do and know before your surgery date.  The packet should include a list of all the medications you should not take starting usually at 2 weeks before your surgery.  These medications will include, but are not limited to, aspirin containing products, stimulants, seratonin supplements, etc.  Would you like to view a typical Medication & Supplements List?  Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities.

How Facial Liposuction Is Performed  
A facial liposuction procedure normally takes about 45 minutes to an hour to perform.  

First, you will have monitoring "pads" attached to you so that the surgical team can properly monitor your vital statistics before, during and after your operation.  When you are brought to the operating room, electrodes will be "plugged" into these pads which are connected to the monitoring equipment.  

Once you are on the operating room table, you will then be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date.  If you had been given an oral sedative or valium prior you will have less anxiety.  They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular "doorway" for anesthesia, antibiotics, and other medications.  If you haven't been given a sedative, it is more stressful for some patients.  If you feel that you may experience anxiety inquire beforehand regarding an oral sedative.  Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time.  It's the initial placement of the IV that may sting a bit.  Some people get heir IV placed in the crook of the elbow, some the hand - it all depends upon your veins though.  So if your veins are not very prominent this can be a problem.  You are then brought to the O.R. if you aren't on the table yet.  After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein.  This is called a "catheter".  The  catheter is taped to your skin so it is not accidentally knocked or pulled out and is ready to be used as a sort of entryway for anything the surgical team deems necessary for your body.  This is usually done before you get into the actual O.R. - by a nurse - and you have a saline bag hooked up to you.  The medications will usually be given with a drip system with this saline.  As said before, the saline will keep you hydrated both during and post-operatively.  

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body.  The the effects of the anesthesia are felt soon after injection or opening the stopper - a few seconds in fact.  It may feel similar to a sensation of "heat" entering your arm or hand at the catheter site.  It then feels as though it is creeping up your arm - then it "jumps" from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.   The anesthesiologist or surgeon will then determine if you are sedated properly, your stats are stable and if you are ready for the surgery to begin.

You will then be marked with a magic marker type pen which will help your surgeon regarding fat removal areas.  You will then be scrubbed with Betadine, the surgical marker markings will remain - although not as dark.  You will be injected with a solution of Lidocaine and epinephrine.  The Lidocaine is a pain reliever, the epinephrine is a vasoconstrictor .  The epinephrine will impede your skin's ability to bleed excessively.

If you have chosen local with oral sedation you may have been given a valium or comparable to calm you and are given either regional or local injections of Lidocaine and the surgical team waits until you are properly numb.

Your surgeon will make an incision about 2 to 4 cm long in the mandible (jaw) angle, under the chin or between the gums and the bottom of the inner lower lip where it joins the gums of the mandible, starting above the second upper molar towards the back of the mouth. 

With the external incision (at the jaw angle) the cannula (a titanium wand attached to a vacuum with a reservoir for the removed fat) will be inserted into the incision and the tip is moved back and forth to loosen the fat, The suction will remove the loosened fat cells and your surgeon will continually pinch your skin between his thumb and forefinger to determine the amount to me removed.

With the intra-oral incision, care must be taken as to not press the cannula directly against the under part of the skin. This can remove too much superficial fat and create dents or lumps. It can also mottle the skin. Some surgeons prefer the external incisions although with proper skill the intra oral technique can produce a wonderful result.

Either way manual fat removal is also an option and for many surgeons - a preference.

The surgical team then performs a sponge and instrument count and your surgeon then closes your incisions with, more than likely, a non-dissolvable type suture for intra-oral sutures and dissolvable sutures or the intra-dermal incisions.  You may have an antibiotic-soaked piece of gauze placed between your lower lip and your gums and a pressure dressing placed around your head such as you would see in a face lift patient.  If you are not familiar with this "look" it involves wrapping a dressing around the top of your head to underneath your chin, sometimes slightly over your ears.  Of course there may be differences in surgical technique depending upon the preference of your surgeon.

You are then wakened gently and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released.  This is dependent upon the individual but may take up to two hours.  Your neck and chin may feel tight and quite tender as the anesthesia wears off.  You may even feel emotional or upset - this will depend upon your body's reaction to anesthesia.  You may also experience "rigors" or shivering.  This may feel uncontrollable and  is usually from the medications - more than likely epinephrine that is used as a vasoconstrictor.  The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable.

Some patients feel nothing different although if you have had General you may feel a little sick - hopefully your surgeon gave you something to lessen this.  Your prescribed medication should alleviate this pain and discomfort.  However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately.  You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home.

The Road To Recovery  
You may be groggy from the anesthetic and/or oral medications and probably won't remember much of the first day or two.  You will have to take it easy and sleep on two pillows to keep your head elevated for 7-14 days - or however long your surgeon suggests.  When you wake up you will notice that your neck and lower face will look even more swollen in the first 3 days. But, as the days go on the swelling will dissipate.  There may be bruising, but this will go away, as well.  So make a mental note of this or you may be shocked into a depression.  Bruising and swelling are a normal occurrence in most surgeries.

You will more than likely experience some discomfort for several weeks - if you had intraoral incisions your diet may be restricted.  You should ascertain all fresh fruits and vegetables have been washed, no raw fish (sushi), very rare meat or other types of foods that may contain high amounts of bacteria.  Eating foods such as this may increase your risk of infection due to the incisions being in the mouth.  You may be instructed to rinse with Listerine several times a day. DO NOT PICK or "tongue" your incisions or sutures!

Although any discomfort should be alleviated by your prescribed pain medication if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon immediately!  Take your temperature regularly.  An elevated temperature could mean an infection.  Take those antibiotics on time.  Also, don't forget if you are a female taking birth control pills that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well.

Your sutures will more than likely be taken out by your surgeon any time between 5-10 days postoperatively.  Even though you may feel better, you must take it easy for the first 3 weeks.  Be careful not to bend over or lift heavy objects. And be careful not to raise the blood pressure for at least 3 weeks as this could cause internal bleeding at your treatment area.  Your blood vessels dilate to allow increased blood flow when you raise your heart rate.  This may cause problems at internal wound sites.   Do not participate in contact sports for at least 6 to 8 weeks - although ask your surgeon what he recommends specifically.

Your swelling will subside within a few weeks, defining even more temporary change in your smile if you have had an intraoral approach, odd sensations of "hollowness" under your chin, tingling, the sporadic sharp pain, or "pulling", burning, and cold sensations.  These usually subside within the first few weeks. 

Risks & Complications Of Facial Liposuction 
Unfortunately, all surgery has risks and complications. With facial liposuction, these include allergic reaction to the anesthetic used and infection.  There could be asymmetry, general dissatisfaction, hematoma or seroma, lumpiness, and/or mottling.

For risks related to anesthesia - please see our Introduction To Anesthesia section.

Numbness is possible, it usually subsides within the first few weeks but it may become a permanent issue.  Puckering of the skin may occur and deeper than desired depressions may result. Excess scar tissue and lumps are possible as well.

The Average Price of Facial Liposuction
The average prices for facial liposuction significantly varies with the technique used, region and surgeon.  Average prices for this procedure is $1,500. - $3,800.US and depends upon the surgeon and region as well as if the surgeon has his or her own surgical suite.  With procedures performed in a hospital or under General with a certified anesthesiologist - prices are usually be higher.

Related Links 
Morris Designs Submental Liposuction Support & Postoperative Garments 
BioDermis Scar Sheeting & Gel

References 
Merriam-Webster Medical Dictionary
personal interviews with various plastic surgeons
Yale Medical Core Curriculum: Facial Lipectomy

* Please note the prices charged for surgeries represented in the documentations of the links above are representative of what an American doctor would normally charge. Of course, our fees are lower but our doctors are more experienced because more patients come to us due to the affordable prices. Thus, the doctors work on more cases (especially oriental patients and many Caucasians).