What is neck and jowl liposuction?

Of all the cosmetic surgical procedures, perhaps the biggest "bang for the buck" is liposuction of the neck and jowls. Any weight gain causes the definition between the face and neck to become obscured. With a short procedure under local anesthesia, fat can be suctioned from under the chin, the jowls, and the neck.

The result can be striking and can simulate massive weight loss. Because fat commonly collects in the jowls and under the chin as we age, liposuction can produce a more youthful definition of the neck and jaw line. In the 1980s neck liposuction was billed as a procedure for people under age 35.

It was felt that skin would hang in older people after fat removal. Indeed, loose skin was a reasonable expectation. But because of a tenth-grade geometry principle, when the fat is removed, the skin must redrape over a longer distance.

(The sum of two sides of a right triangle is longer than the hypotenuse!) So when fat is removed, by stretching over that longer distance the skin appears to tighten. Add to this the scarring that always occurs following surgery, and the skin really looks tighter. In only a small number of people does the skin hang.

And so, because of living geometry, in the early 1990s liposuction of the neck and jowls began to be performed in older people. I have successfully performed this procedure on women as old as 68. Sometimes the neck bands are hidden by overlying fat.

When the fat is removed, the bands may become visible -- usually in a few years. If the bands are visible before the surgery despite the fat, they should be tightened at the time of the liposuction. This procedure is called a platysmaplasty or "band-lift."

Your plastic surgeon needs to examine you thoroughly prior to surgery. Sometimes the fat of the jowls really comes from inside the mouth (buccal fat). You'll feel it when you suck in your cheeks.

It cannot be removed with liposuction. And sometimes the fat is underneath the muscles of the neck, requiring more than just liposuction. Liposuction of the neck and jowls can be done on overweight people, and on people with early jowls from aging.

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