Generally speaking, liposuction of the neck is reserved for patients younger than 40 to 45 years of age since the skin elasticity diminishes afterwards and the tissue may not tighten back by itself. The principle of the lipo-suction involves evenly removing the excess fat in the subcutaneous space between the skin and the underlying Platysma muscle under the chin and jowl area, and also covers the entire neck area from ear to ear. Just as important is the tunneling made by the liposuction cannula, which creates a controlled adherence between the skin and the underlying muscle, allowing an even greater tightening effect on the skin. The liposuction is performed through a small incision made in the natural crease under the chin which usually heals imperceptively. In certain patients with significant “fat pad” under the chin, the incision needs to be slightly widened for direct excision of the fat pad “deep” to the Platyma muscle, in addition to the standard lipo-suctioning of the subcutaneous fat “superficial” to the Platsyma muscle. Prior to surgery, Dr. Kang will carefully examine the patient, and recommend a chin implant if a small chin is present, which will yield a greater enhancement by providing greater lengthening and sharper delineation between the chin and neck. Wearing a snug neck band for a week following the surgery is important to assure good adherence between the skin and the underlying muscle.
Facial/Neck Lipo-Transfer Surgery
Lipo transfer or fat grafting surgery is a great option for replacing loss of volume and hollowing that occurs in the face, particularly in the cheeks and around the eyes. The best candidates for lipo-transfer are patients who experience deflation of their facial volume more quickly than any other aging process. Based on your genetical make up (just look at the aging changes of your parents), your exercise tendencies, sudden weight loss, early dental extractions, you may experience early “deflation” of the youthful volume of your facial shape. Younger patients in 30’s or 40’s, may only need to volume enhance the deflated zones in the face, whereas older patients may require both volume enhancement and a lifting procedure. The surgery is two-fold: first, fat is harvested from the area where you have the most resilient fat in your body, usually the belly and the thighs for women and belly and love handle area for men. The fat is then gently harvested using a handheld syringe rather than liposuction machine to minimize traumatizing the fat during the harvesting process. The harvested fat is separated from impurities using a centrifuge and transferred into small syringes. Second, Dr. Kang uses a “micro-droplet” technique using many little gentle passes to transfer the fat droplets into the needed areas for the smoothest results and the longest effect possible. At the time of consultation, Dr. Kang will advise you as to the best zones of your face (high/mid/low check area, corner of mouth, jowl and jaw area, tear trough area, upper eyelid area) for the fat transfer to look as youthful and natural as possible. It is important to realize that fat transfer is mainly for volume restoration and not to erase all the fine lines, and wrinkles on your face, for which, Dr. Kang will recommend combined therapy with more “viscoid-elastic” injectables, such as Juverderm or Restylene. On the other hand, a unique unexpected gain in some patient is a long-term improvement in the overall tone, texture, and even fine wrinkles of the face which appears to last even after the fat volume enhancement depletes with time. Final important point of lipo-transfer is that the down-time associated with fat transfer can match any surgical procedures and needs to be considered in matter of weeks and not matter of days. Because of the prolonged recovery period, lipo-transfer is ideal while another surgical procedure is being performed at the same time. Patients wishing no down-time whatsoever are given a choice of other injectable fillers, such as Restylane, Radiesse, or Juverderm, which can achieve similar volume enhancement, although with less lasting effect.