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Liposuction: New Hope For A New Figure Through The Art Of Body Contouring
By Dr. Leon Forrester Tcheupdjian, M.D.
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Dr. Leon Forrester Tcheupdjian, M.D., respected scientific researcher, teacher innovator and surgeon. As the Medical Director / Chief Surgeon of a Chicago, Illinois Plastic Surgery Practice, Dr. Tcheupdjian has supervised and performed probably more liposuction procedures than any other American doctor.

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Chapter XI

Liposuction of the Face and Neck

Donna knew she was getting older. Every time she looked in the mirror, she was reminded of her age.

It wasn't that she minded being-let's say, "mature." It's just that when people looked at Donna, her rather attractive features seemed to be swallowed up in her all-too-fleshy neck and double chin.

Until she heard about liposuction, Donna was more or less resigned to living with her appearance. But then she began to wonder what liposuction could possibly do to help. She found it could do quite a lot.

When liposuction was first becoming popular, most patients thought of it as a way to reduce their large, obvious bulges, especially in areas like thighs and buttocks. The "tummy tuck," too, was a popular approach toward a more attractive body image.

As surgeons gained more experience in liposuction, however, they became more skillful in body contouring. "Why," they began to ask, "can't the technique of sculpturing away the excess fat under the skin be used for more delicate areas?"

The face has always been of prime importance to cosmetic surgery. In fact, the phrase "face lift" has almost become synonymous with cosmetic surgery. Because the face is so visible, cosmetic surgery for the cheeks, jowls, and the area around the nose and lips has always been popular.

Before the advent of liposuction, treatment of these areas was almost always a rather involved process, requiring an operation that took considerable time. The traditional face-lift procedure also often required longer incisions than those used in liposuction, so there was more chance of scarring.

Several years ago, a patient like Donna, who was somewhat obese, might have been told by her physician that she could not have a face-lift until she had lost weight. Today, many surgeons would combine the face-lift with liposuction, removing excess fat cells from neck, cheeks, face, and jowls at the same time.

That is what happened to Donna. She was skeptical at first-until after the surgery. Then she was delighted with the results.

Her double chin, which had always bothered her, was reduced substantially, giving Donna a younger, less matronly appearance. Liposuction of the neck area, as well, reduced the somewhat jowly look that Donna had begun to acquire. And the flabby skin she disliked so much seemed tighter and more attractive. Today, she feels much better about her appearance.

CHIN AND NECK PROBLEMS
People who have double-or even triple-chins are often the victims of a genetic trait. Others may be suffering the consequences of a good deal of extra fat, and still others may simply have reached the age when the flesh tends to sag.

Such double or triple chins, as well as looseness of the skin around the neck and chin area, can be dealt with safely and effectively by liposuction.

In addition, liposuction can be used to extract excess fat cells from the neck, cheeks, face, and jowls.

TINY INCISIONS
All liposuction procedures in the face and neck region are relatively easy and uncomplicated from a medical standpoint. Your surgeon will discuss with you just what to expect, but often, liposuction surgery can be done here with multiple injections of a local anesthetic, and does not require general anesthesia.

The incisions through which the fat will be extracted are usually positioned on each side of the area being treated, in as inconspicuous a place as possible. They are small-most likely, only about 3/8 inch long-and can almost always be closed without visible suture marks. There is little likelihood of any undesired consequences, such as scarring or keloids. The operation itself, whether done alone or combined with a "face lift" procedure, generally takes only a short time.



1. A front view of this patient's chin and neck before liposuction.

2. Side view of the same patient's chin and neckline before surgery.

AFTER SURGERY
Within an hour or two after liposuction of the face, neck, or jowls, most patients return home. Even though you may feel able to drive, it is better to have a friend accompany you and do the driving. Indeed, most surgeons will insist that you do.



1. Common location of fat deposits on chin and neck.



2. Side view shows fat deposits on neck.

3. After liposuction, this same patient showed a much more Attractive profile.



4. This patient's fat deposits formed heavy jowls and a double chin before liposuction

5. Following liposuction, heavy jowls and double chin disappeared.

Unless your surgeon tells you differently, you will almost certainly be able to return to work within a day or two. In fact, if you feel you want to, you may be able to go to work the day after surgery.

Some patients prefer to schedule the operation on a Friday, and return to work after the weekend. There should be minimal swelling after the surgery, so that your appearance will not be a problem.

WASHING AND MAKE-UP
Your doctor will probably bandage the area in which liposuction has been performed, using a compression bandage to aid healing and to keep the skin from sagging. Follow the surgeon's instructions about when to remove the bandage.

Generally, you will visit your surgeon several days after the liposuction surgery. At that time, he or she will check the progress of your healing and remove any small sutures. Once the bandage has come off, you will probably be allowed to wash the site gently with a mild soap and soft cloth. Some patients find it more soothing to cleanse the skin gently with luke-warm water and a ball of soft cotton.

It is not unusual to have bruises, discoloration, or swelling shortly after liposuction. Do not be alarmed if this occurs. Your body often reacts to the trauma of surgery by setting up an inflammatory reaction, which subsides before too long.

Patients who have bruises often benefit from wearing a skin cream that can be smoothed on to camouflage the discoloration. I prescribe one that is easy to use, and has helped many patients who have returned to work or to an active social life before the bruises have completely faded. Make-up can be worn over the cream, if a patient desires.

It is a good idea to avoid wearing heavy make-up for a week or two following the operation, especially in the area of the incisions, but this is a point you will discuss with your surgeon. Follow your surgeon's specific instructions. He or she may recommend that you switch to a hypoallergenic make-up while the healing process is going on.

You may also want to discuss with your surgeon whether or not you should wear a sunscreen or a hat to shade your face from intense sun for some weeks after liposuction. If surgery was performed in extremely cold weather, you may find that wearing a soft scarf for a short time after the operation is comfortable, and helps to protect any sensitive areas from cold.

Obviously, a certain amount of tenderness and sensitivity is to be expected, following your liposuction surgery. You should discuss carefully with your doctor the areas which will be affected, and what you should expect. The post-surgical effects usually look much more alarming, if you are unaware of what to expect. In reality, they are usually quite minor, and will disappear very quickly; but you will feel better about them if you know fully beforehand, what to expect.

MESSAGE AND EXERCISE
Down-stroking. As soon after surgery as your surgeon gives permission, (usually three to four days), you will want to start massaging your chin and neck area. Gather the skin gently, stroking it with a downward, soothing motion towards your heart.

Circular massage. Another easy massaging technique is to stroke the area in which liposuction has been performed with a smooth, circular motion, tracing small circles on your skin with the tips of your fingers. The pattern should be repeated until you have covered the entire area. You can do this massage a number of times a day.

Pinch/release. Another massage you can use after liposuction of the face, chin, or neck is to pinch your skin gently and, after a slow count to five, release it. Grasp as much of your skin in the chin/neck area as you can comfortably hold between your thumb and one or two fingers. Full it gently away from your body. Count slowly to five. Release the skin. Then repeat the pinch/release motions in another spot.

Your surgeon will tell you how soon after surgery you can begin this massage. in general, in my opinion, a week after liposuction is the appropriate time to start.

The pinch/release massage helps to reduce the inflammatory reaction by improving circulation. It stimulates the flow of blood, thereby aiding healing.

Gradually increase the time of massage-starting with one or two minutes at a time, and working up to five minutes or so. Do this about 10 times a day. It will help blood circulation and speed the healing process. Do not be afraid to touch the area in which liposuction has been performed. It may be slightly numb at first, or even a bit tingly, like a foot that's gone to sleep, but that sensation will gradually go away.

1. Facial grimaces. Within three or four days after surgery, or as soon as your physician tells you it is all right to do so, begin practicing facial grimaces. In addition to smiling frequently, deliberately distort your facial features by twisting your mouth and jaw into strange contortions. When you first begin, doing these movements in front of a mirror may help you. As you become more confident and less self-conscious about them, you can grimace while you are driving a car, doing household chores, or whenever you have a few moments. These exercises can be done many times a day.

The reason for grimacing is that it helps pull up the muscles in the face, chin, and neck area, thereby tightening your skin after liposuction, and helping you to heal faster and more attractively.

2. Neck extension. An easy exercise that will benefit the face, chin, and neck area is to extend your neck. Bring your head down towards your chest. Then, slowly bring it back up again to a normal position. Continue the motion backwards, until you are looking up at the wall or a portion of the ceiling, with your chin pointing up and your head tilted backwards. Next, return to your normal position, and begin again.

Do not perform this exercise hurriedly or with a jerky motion. Instead, concentrate on doing it smoothly and gently. You will find it helps avoid undesirable adhesions, and stretches the skin gently, keeping it pliant and supple.

3. Neck rotation. With a smooth, unhurried motion, turn your face and neck from side to side as far as you can go. You are stretching your skin and your underlying tissues. At first, soon after surgery, your range of motion may be somewhat limited; as the healing process continues, and as you practice this exercise, you will gradually be able to move your neck farther in each direction.



1. Front facial view shows key areas of facial musculature.



2. Side facial view shows where key masculine areas appear in profile.



3. The arrow indicates the location from which the liposuction proceeds



4. The cervicomental angle is the area under the chin.



5. With fat removed, the patient's profile has a normal contour.
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Liposuction: New Hope For A New Figure Through The Art Of Body Contouring - By Dr. Leon Forrester Tcheupdjian, M.D.
ISBN 0-9621284-1-4 | Library of Congress registration #: 2-414-199
copyright © 1988-2006 Dr. Leon Forrester Tcheupdjian M.D.
Published by Dr. Leon Forrester Tcheupdjian M.D. 875 Rush Street Chicago, IL 60611


All rights reserved. No part of this book may be reproduced in any medium whatsoever, including photocopy or other electronic medium, without the express written permission of Dr. Leon Forrester Tcheupdjian M.D..