Is there a safe Vaser lipo way to remove subcutaneous face fat deposits avoiding nerve injury?

Thank you for your question regarding if there is a safe way to have Vaser Liposuction in the face while avoiding nerve injury. In my opinion, it is safe to remove fat from around the marginal mandibular nerve. It will be important for you to go to an experienced board-certified plastic surgeon who has performed this procedure many times to achieve optimal results. Liposuction is slightly dangerous in that it is performed with an unseen cannula tip. That means that the fat is aspirated or sectioned without seeing exactly where the tip is. However, an experienced board-certified plastic surgeon will know where the tip of the cannula is for the removal of the fat. Therefore, if you can find an experienced board-certified plastic surgeon who has done this procedure before, I would suggest that you go for it. I hope this helps. Good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Liposuction of the face is typically not a recommended procedure for multiple reasons. One reason is what you alluded to as there is no way to guarrantee that you will not hit a nerve no matter what layer you are in. The second, is that taking fat away from the face, will result in loose skin that will look worse than before especially if you feel that your have a generous shape to your face. This is because the skin will sag and create worse jowls. The definitive correction is a face and neck lift.

Plastic surgeons are well trained in knowing areas where facial nerve damage is more likely.

VASER is an energy-based device that is more aggressive than traditional forms of liposuction and has a higher likelihood of creating nerve damage.

Nerves have a fatty covering that’s required for them to proper functionally called the Mylin sheath. Anything that removes fat can also strip this fatty covering from the nerve.

Liposuction induced facial nerve injury it’s usually temporary.

Simply using gentle technique with small cannulas is often sufficient to minimize the chance of nerve injury.

Still, if you take fat off in the proximity of a nerve that has fat around it you’re going to take the risk of nerve injury.

Whether the risk is justified or not it’s a discussion that varies among patients and providers.

There is no particular technique other than being gentle and using small cannulas that has any proven advantage.

Do the procedure and take the risk or live with your current fat distribution.

The injury is typically temporary but upsetting to patients while in the healing phase.

I suggest patients not try to reinvent the wheel by trying to understand more about plastic surgery than those who have gone through the formal training and have years of experience.

Best,

Mats Hagstrom MD