SUBMENTAL LIPOSUCTION, AN ALTERNATIVE TO LIPOLYSIS WITH MESOTHERAPY INJECTIONS OR A COMPLEX SURGERY?
SUBMENTAL LIPOSUCTION, AN ALTERNATIVE TO LIPOLYSIS WITH MESOTHERAPY INJECTIONS OR A COMPLEX SURGERY?

Summary/Abstract: Submental liposuction, which can be performed alone or as part of a neck lift, is a procedure that contours the jawline and cervicomental angle by removing fat tissue using the tumescent technique. As with any aesthetic procedure, a complete physical examination of the neck is essential for proper patient selection and achieving excellent results. This technique is usually applied to younger patients who have toned skin, elasticity, the ability to contract, and good adherence of the skin to the underlying structures. We treated 20 patients in our practice with submental liposuction, either as a single procedure or combined with a neck lift, to improve the contour of the submental and neck area. We monitored long-term results as well as patient satisfaction, complications, and side effects. A thorough examination is essential because some conditions cannot be treated with liposuction alone, and it is important for patients to be prepared to avoid disappointment. Very thin skin, “like onion peel,” predicts a poor outcome except in cases combined with lifting. The presence of multiple and deep horizontal or oblique wrinkles on the neck indicates that the skin will not retract properly after surgery. With aging, fat may accumulate above or below the platysma. Fat above the platysma can be easily removed through liposuction. With the neck in extension, we assess whether the fat is above or below the platysma. Typically, a medium fat thickness of 1.5–2.0 cm in the pinch test is indicative of a good outcome. A low position of the hyoid–thyroid complex may limit the achievement of a clear cervicomental angle, compromising the final result. In patients with visible platysmal bands, whether or not there is animation, liposuction should be performed carefully as it may accentuate this deformity. In those with prominent submandibular glands, aggressive liposuction may make them more visible. Submental liposuction should be performed with limits. Excessive fat removal can cause contour irregularities or make the neck appear excessively thin (skeleton effect). What may seem like a minimally invasive and not very complex procedure to a non-specialist in plastic surgery can result in disappointment and loss of trust in plastic surgery. Special attention should be paid to aesthetic complications, which have as much impact on the patient’s psychology as hematomas, infections, and other complications.

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