Submental liposuction refers to the removal of fat from the neck, in the region underneath the chin. This procedure is performed to provide a crisper and cleaner jawline and neck. It is commonly performed as a stand-alone procedure though it can complement other surgeries such as buccal fat removal and chin augmentation very well. It’s certainly possible to perform liposuction of the neck in the office, under local anesthesia with oral sedation, to make you relaxed. We also perform this procedure at the surgery center if patients desire deeper (IV) sedation.
Your liposuction consultation with Dr. Mehta will last approximately 45 minutes. Dr. Mehta will begin by asking you what exactly bothers you about your appearance and what improvements you would like to achieve. Dr. Mehta will then obtain a careful history, including medical conditions that may affect your ability to undergo and recover from surgery. Any history of adverse reactions to anesthesia or medications commonly given before, during, and after surgery is also determined. This discussion is followed by a thorough examination of your face and neck. Prior to the examination, Dr. Mehta (or our Nurse, Shannon) will photograph your face from several different angles.
We will also discuss whether you are a candidate for any additional procedures which may help the appearance of your neck, jawline, and chin. These may include chin augmentation (with an implant or filler), platysmas plication (neck band tightening), jawline contouring (with filler or Botox), Coolsculpting of the neck, or Ultherapy of the neck.
After your consultation, Jill, our Office Coordinator, will assist you with scheduling your surgery, pre- and postoperative appointments and schedule a second consultation for you, should you so desire.
After this initial consultation, you would return for a preoperative visit, two or three weeks before your surgery. At this visit, Dr. Mehta and Shannon will again go over your list of medications and supplements, as it is usually necessary at this time to discontinue any products that can increase the risk of bleeding during or after the surgery. These include, but are not limited to, aspirin, ibuprofen, heparin, warfarin (Coumadin), Plavix, vitamin E, fish oil and numerous other supplements. The decision to stop any of these prescription or over-the-counter products is made in conjunction with your primary physician. Medical clearance and other tests may need to be obtained, depending on your age.
Dr. Mehta will give you prescriptions for your pain medication (or call your pharmacy) at this visit as well. This allows you to pick up these important medications prior to your surgery, so that postoperatively, you and your caretakers can rest and concentrate on your recovery. Dr. Mehta will advise you to pick up Arnica Montana and Bromelain, two homeopathic products which reduce bruising after surgery. These are taken as directed, beginning immediately after surgery. You will be given detailed preoperative and postoperative instruction pamphlets, to read prior to your surgery. It is important to minimize salt intake and avoid alcohol for three days leading up to your surgery.
Lastly, you will have the opportunity to spend time with the office coordinator, to answer any logistical questions related to your surgery. Your final surgical fees are settled at this visit as well.
On the day of surgery, you will arrive at the surgical center with a friend or family member who will drive you home and care for you after your surgery. It is imperative to come in on an empty stomach, not eating or drinking anything for at least 8 hours prior to your surgery. This includes water and chewing gum. You should wear loose and comfortable clothing, including a shirt that buttons in the front to avoid having to pull anything over your head after surgery.
The operating room nurse will meet with you first to go over your instructions in detail. The procedure is generally done under local anesthesia with mild sedation, either with medications given by mouth or through an IV. If additional procedures are being performed requiring deeper anesthesia, you would meet your anesthesiologist, who will have carefully reviewed your medical and surgical history. You will have the opportunity to ask the anesthesiologist any questions you may have at this time. Finally, Dr. Mehta will meet you and your friends/family to answer any last minute questions as well.
After local anesthesia and sedation are administered, the surgery is begun by creating two tiny (2-4 mm) incisions under the chin. Using a blunt liposuction cannula, the fat is gently removed from the neck. The neck is repeatedly palpated to ensure an even and thorough fat removal. Once enough fat has been removed to achieve the desired effect, the incisions are closed with one or two sutures. A compressive head and neck dressing is then applied, to hold pressure on the neck during the recovery process. After surgery, you will awaken in the recovery room, where your vital signs are carefully monitored by the anesthesiologist and recovery room nurse.
After approximately one hour in the recovery room, you will be discharged home, in the care of a responsible adult for the first night. Your friend or family member will help ice your neck, assist with your pain medications, and help you with your normal daily activities. You will sleep with your head elevated at 30-45 degrees. At this time, you will begin taking your prescribed medications as well as the Arnica Montana and bromelain. Eating fruits such as pineapple and papaya are encouraged as well, as they are thought to help minimize bruising.
The compressive neck dressing is removed and a Velcro head/neck band is reapplied, to be worn as much as possible over the subsequent week. Over the first 48-72 hours some patients develop mild bruising and swelling around the neck, though pain and discomfort are usually mild. Patients are up and around the same day as their surgery and usually Tylenol provides enough pain relief. Prescription pain medication, such as oxycodone, is also prescribed, just in case. Often patients will work from home though most avoid work or social situations for around a week.
Your diet should be mild in flavor for the first day after surgery, to minimize nausea. A lower salt diet is advisable for the first few days after surgery, as this may help to reduce swelling. You should avoid any vigorous activity or heavy lifting for 10-14 days after surgery. Your next visit will be 6-7 days after surgery, to check your progress and remove sutures. Your neck may be mildly swollen and bruised at this time, though this can usually be covered with makeup. The majority of the swelling and bruising disappears over the subsequent few days. On average, patients return to work at 8-10 days after surgery though this certainly varies depending on one’s degree of bruising/swelling and comfort level.
The next visit will be at 3 weeks, followed by every 3 months until the one-year mark. The final “after” photographs are taken at this one year follow-up visit.
Liposuction under the chin is an excellent technique to achieve a cleaner and more well-defined neckline. The procedure has a brief recovery period with minimal discomfort.
If you have any additional questions or would like to schedule a consultation, please contact us.