Facial Liposuction

I had buccal fat removal done but it thinned my upper cheeks, making my lower cheeks look even fatter. I'm otherwise slender: 5'5" and 125 lbs. Also can facial liposuction be done under local/in-office? Can you recommend anyone in the San Diego, CA area?

Doctor Answers 12

Facial liposuction is easily performed under local in the office

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Dear Hatemycheeks

I read your question and then I saw your picture and did a double take. Honestly you so don't need a face liposuction. First, let's talk about this and then I will discuss my concerns and then tell you what I think will help you.

General plastic surgeons are trained to do everything under general anesthesia. It is like a cultural thing. However, they are not the only cats in town to do highly competent liposuction. Dermatologist actually get sued almost 100 times less often than general plastic surgeons for liposuction malpractice and they perform almost identically numbers of cases. Dermatologists tend to prefer liposuction under local anesthesia.

I prefer face and neck liposuction under local. It is a procedure that typically is performed on Thursdays in my office and people return to work on Monday with virtually no evidence that anything was done. Good stuff! In your area Kim Butterwick is a high skilled derm surgeon with an international reputation who performs this and a little further north is Jeffery Klein the derm surgeon who invented tumescent liposuction.

However in looking at your photo, I don't believe that you needed your buccal fat removed and I don't believe that you need facial liposuction. (Although we live in a great country where if you knock on enough doors someone will do what you are asking for whether it is right for you or not)

What I see is a very attractive youthful face with loss of volume in the nasolabial fold and below the corner of the mouth on each side and this makes you look like you have a jowl. Filling these spots with Perlane would make a huge difference for you and no surgery.

On last thing, I also wonder if you have a component of condition called body dysmorphic disorder (BDD). Psychologists have very particular criteria for this condition. But basically, people with this condition are highly sensitive to subtle appearance issues that others may not see or have difficulty understanding. Other signs include a preoccupation with these appearance issues that including thinking about the problem for hours a day or feeling so self-conscious that social situations are avoided or there may be feelings that others are commenting or laughing about the perceived flaw.

It is important to understand if this is an issue because studies have shown that surgeons have difficulty understanding the cosmetic concerns of those with BDD. This can lead to a series of well intended but disappointing surgeries. Personal insight into this disorder by working with a psychologist can be helpful. However, many with BBD are absolutely convinced that they are just one surgical procedure away from what they are looking for and are reluctant to seek psychological assistance even as surgery is destroying their face.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Consider microliposuction only

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You do have mild excess jowl fat and this can be conservatively reduced by using small cannulas under local anesthesia in a sterile office surgical suite. This is called microliposuction. I use very small cannulas with diameters of 1.2 to 1.7 mm for this. Minimal bruising and minimal discomfort are expected, and it is important not to over correct. Consult a qualified board certified surgeon, and ask to see before and after photos of his patients, because results do vary somewhat with this procedure.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Facial liposuction

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In general, facial liposuction in a limited area can be performed under local anesthesia if you can tolerate the injection necessary to anesthetized the area of concern. However, your surgeon should carefully analyze your facial anatomy to determine what modification would give you the result you are looking for. While removal of fat might, laxity of the skin might also be an element as well as anatomy of the adjacent areas such as the chin. Facial liposuction is tricky and has little room for error. I like using the syringe method because I can be very precise about how much to remove, about symmetrical removal, about not over-suctioning, and being gentle. It is much better to be conservative than aggressive in this situation.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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Facial Liposuction

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I do not believe you are a candidate for facial liposuction, however if you feel that your cheeks are too thin after buccal fat removal you may cosider fat transplantation or injection of Radiesse or Scalpta into the flattened area.Facial liposuction would help to contour lower part of the face, submental areas and neck and are usually done under sedation and local anesthesia by a board certified plastic surgeon in your community.

Liposuction works very well under local anesthesia

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I currently do ALL of my liposuction under local anesthesia.  Patients are very comfortable with a little valium or xanax by mouth - just to eliminate their anxiety.  The local completely eliminates any discomfort.

Go ahead and have the procedure.  You'll be glad you did.

Thomas P. Sterry, MD
New York Plastic Surgeon
4.8 out of 5 stars 23 reviews

Lipo under local

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You can definitely have liposuction done under local anesthesia. The better question is will it solve the problem that you don't like. It seems that you don't like the jowl area. This can sometimes be treated with liposuction, but will sometimes require something different for the best results. 

Choose the best procedures to match your needs and concerns. Always consult with doctors that are certified by the American Board of Plastic Surgery to ensure that you are in good hands.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
4.9 out of 5 stars 21 reviews

Facial liposuction

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Facial liposuction is great for addressing your concerns. It can be performed in the office under local anesthesia if your plastic surgeon is set up that way. To find a local board certified plastic surgeon, check out the American Society of Plastic Surgeons website. Then, interview with several of them and see who you're most comfortable with. Good luck!

Facial Liposuction

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You do not need facial liposuction! 
I am seeing more people asking about facial liposuction and generally they are people who have had bad results from facial fat grafting or fat transfer.

Please do not have liposuction of the face. This is not a surgery for you. Should you elect to have any surgery, be certain you select a physician who has hospital privileges to perform that surgery, whether or not the surgery is performed in a hospital. If at some time you should elect to have a filler or non-surgical treatment performed, look for a highly experienced medical provider in a setting that is owned and operated by a physician.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Facial Liposuction

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Facial liposuction can be done under local anesthesia if desired but I recommend very small cannulas such as 1.7mm and 1.9 mm.  It is important to not overdo the face when aspirating as this area is very thin and shows irregularities well.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 117 reviews

Liposuction face

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agre with Dr Yuan  would be cautious as removal of fat may lead to more sagging skin..if it doesnt bother you too much i would probably leave it alone..if it does then conservative liposuction should give you what you want..GL

Michael K. Kim, MD
Fort Myers Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.