30, thin, what decreases the risk of nerve damage during submental chin lipo?

The risk of nerve damage during submental (under the chin) liposuction is low when performed by an experienced surgeon, but it is an important consideration—especially in thinner patients with minimal fat, where the margin for error is narrower.

Here are key factors that can reduce the risk of nerve injury:

Surgeon's Experience & Technique:
The most important factor is choosing a board-certified, experienced surgeon who understands facial anatomy well. Precision and a conservative approach are essential, especially near the marginal mandibular nerve, which controls muscles used in smiling.

Avoiding Aggressive or Deep Suctioning:
Overly aggressive or deep fat removal increases the risk of trauma to nerves. A delicate, superficial approach is safer in patients with minimal fat.

Use of Local vs General Anesthesia:
Whether the procedure is done under local or general anesthesia does not directly change the risk of nerve damage. However, under local anesthesia, the patient can still move or react if the nerve is stimulated, which can provide subtle feedback during the procedure. Some surgeons prefer this for added safety.

Avoiding Energy-Based Devices in Thin Patients:
Devices like SmartLipo (laser-assisted liposuction) can increase heat and risk of thermal injury, especially in areas with thin skin and little fat. Avoiding these in thin patients, as your surgeon mentioned, is often wise.

Preoperative Planning and Marking:
Careful preoperative marking of anatomical danger zones reduces risk. A thoughtful surgical plan tailored to your facial structure is key.

Post-Op Timeline for Nerve Recovery:
In the rare cases where temporary nerve weakness occurs, it typically resolves within weeks to a few months. Since your wedding is at the end of December, you have sufficient time for healing if the procedure is performed soon.

In summary, nerve damage is rare and usually temporary when proper technique is used. You can further lower your risk by working with a conservative, experienced surgeon who tailors the procedure to your anatomy and avoids overly aggressive approaches.

the risk of nerve damage in liposuction is technically a neuropraxia, and expected to heal in 3 months. However, we dont expect a direct injury to nerve as the liposuction is done right under the skin and over the platysma muscle of neck, and the nerve courses deep to the platysma. Doing that under local anesthesia doesnt change the risk, there will be only nerve block for a couple of hours.

With Liposuction in the chin/neck area there is always a risk of temporary or permanent paralysis of the nerve leading to the lower lip. This causes a crooked smile. In majority of the cases it comes back in 3 months.
Going under anesthesia does not increase the risk. It mostly depends on the surgeon's experience.
Regards
Dr. J

It would be best to post set of facial photographs including your neck to make a determination about the right procedure for you. Liposuction can only accomplish removing fat deposits above the platysma muscle, while a surgical neck lift with a platysma plasty is required if your fat deposits are located below the muscle. Liposuction alone will be ineffective if you're fat deposits below the muscle. Liposuction can be done under local anesthesia as an outpatient procedure. As long as the cannula is kept above the platysma muscle, you should not have any issues with nerve damage

The nerve were concerned about when doing this procedure is the marginal mandibular nerve, which is a branch of the facial nerve.
This nerve is deep to the muscle layer below the jawline and becomes superficial as the nerve crosses the mandible.
If the surgeon stays below the jawline, then the chance of nerve damage is low.
If the surgeon does liposuction in the jowl then they are working right where the nerve sits.
I do this procedure on a regular basis and generally never put patience to sleep for Liposuction.Delivering consistent quality Liposuction results is more difficult than most people realize.
The number of plastic surgeons who approach mastery of this procedure is quite small.
I cannot emphasize enough the importance of provider selection.
If not done well, this procedure can leave people disfigured.
Liposuction results should be viewed as permanent and irreversible.
Insist on providers showing you an impressive collection of before, and after pictures of previous patient who had very similar facial characteristics to your own(same age, degree of skin laxity, amount of subcutaneous fat, and mandibular size and shape).
I generally always recommend patients have multiple in person consultations before selecting a provider.
Best,
Mats Hagstrom MD