Chin Lipo (Tumescent): Open Versus Closed Drainage?

Open Incisions vs Closed for Liposuction is highly variable based on surgeon's preference. If they are to be closed then it would be right away, not 3 days later. Most Board Certified Plastic Surgeons close liposuction incisions regardless of the type of liposuction used (Smart Lipo, Ultrasonic liposuction, conventional or PAL - power assisted liposuction. In my more than 2 decades of practice and trying each of these devices, I have not found any prolonged recovery by closing incisions. On the contrary I feel that I have prevented the mess and hassle to the patient. The ultimate scar has a better chance of being smaller if sutured. I do not see an advantage in not putting in a stitch.

No ultimate difference with or without a stitch.  The scar just heals a bit better with a stitch.  The body absorbs the fluid readily.  Swelling after the surgery will have more fluid in the area, but it will not be draining, reabsorbing so don’t be too concerned about open drainage.  Open drainage is more of an issue with abdomen or leg liposuction.

Plastic surgeons are not the only type of specialist that offer this service.  Chin liposuction is a very comfortable procedure that can be done in an office procedure room under local anesthesia.  The procedure is best when performed with microcannulas.  The largest of these are less than 2 mm in diameter.  They can be advanced under the skin through a tiny poke that does not need a stitch.  My patients have this procedure on a friday and are back at work on Monday with minimal swelling and often no bruising.  However, the larger the cannula the surgeon used to do the liposuction, the bigger the incision.  When the incision is big, it will need to be sutured closed to minimize the scar.  Regarding "open" drainage, practically, there will be a small amount of drainage but within hours, these wounds will stop draining.  This is normal and the volumes involved here are minimal so closing a small would with a stitch or leaving the small wound to close on its own really has no bearing on out come.  It might be reasonable for you to consult a different specialty for this procedure like a derm surgeon who offers tumescent liposuction.

Most suture this area. The concept of open vs closed is not usually used in chin liposuction. Closing also allows better scar formation. 

Liposuction of the submental area and neck is a limited size procedure. As a result, there is no need to employ the concept of drainage. The amount of fluid that needs to be resorbed is small and within the capability of the body to do so. Therefore, closing the very small submental incision simple helps it heal better and more quickly. If one really wanted to use drainage for neck liposuction, the incision would have to be at the bottom of the neck to work with gravity. You may be confusing the drainage principle with larger body areas of liposuction, particularly when Smartlipo is used, where keeping the small incisions open does help expell a lot of fluid in the first few days after surgery when combined with compression wraps. Unlike the neck, these body areas benefit from having larger amounts of fluid removed so the body has less to absorb.