Could submental liposuction puncture lymph nodes?

Question

I am looking to undergo a Laser Lift with Precision Tx, which involves liposuction and laser treatment to tighten skin in my submental area. I began thinking recently about the risks of liposuction in such a delicate area. I was wondering if it is possible for the cannula to puncture areas inside the neck such as lymph nodes or my voice box? I am undergoing laser tattoo removal, so I often have swollen lymph nodes. Thank you!

Semih Yildiz, MD, FEPOBRAS · Answer

Submental liposuction is usually performed in the superficial fat layer under the chin, not deep near the voice box. With proper technique, injury to deeper neck structures is uncommon. Lymph nodes are present in the neck, so an experienced surgeon should examine the area and stay in the correct tissue plane, especially if you have enlarged or tender nodes.

The more practical issue is timing. If your lymph nodes are actively swollen from tattoo removal, infection, inflammation, or another cause, tell your surgeon before proceeding. They may want to examine you, wait until the swelling settles, or have persistent/enlarging nodes evaluated first. Ask your surgeon exactly where the cannula and laser fiber will travel, what depth they use, and whether your current lymph node swelling changes the plan.

Sergei Kalsow, MD · Answer

The lymph nodes are under the platysma muscle, and liposuction is performed over that muscle.  The surgeon has to not be in the right plain to injure anything.  However, injury to the lymph nodes is not consequential.  Voice box yes, but then you have to be all the way in the trachea, which would be very hard to do.

Connie Hiers, MD, FACS · Answer

If liposuction is done by a properly trained plastic surgeon, your voice box and lymph nodes will not be damaged. they are not in the area of the fat being removed.

Mats Hagstrom, MD (license on probation) · Answer

There are plenty of structures in the neck that can be injured. Most of them are deep to the muscle layer and the chance of having injury to important structures is very really low.
By far the biggest complication or serious outcome is being left disfigured from not having chosen your surgeon well.
There is very little advantage to any particular form of liposuction such as adding laser treatments heating devices, using ultrasound like VASER etc.
The truth is Liposuction results are purely based on only two variables.
The first is your candidate seat for the procedure and the second is the skill and experience of the provider.
Most people seeking this procedure do not have an abnormal fat distribution.
The issue is causing the problem is not actually related to fat it is almost always related to bone structure.
Almost 100% of people seeking this operation have a dental overbite occlusion and profile pictures will show the upper lip have a more forward projection in the lower lip.
When the mandible is small compared to the Maxilla the platysma muscle will drape the neck in an oblique fashion creating a premature double chin with loss of jaw line definition.
Loose skin does not get treated by anything other than surgical excision.
Regardless of all the claims the truth is that there is no treatment for skin laxity other than surgical removal.
As great as it sounds laser liposuction last favor in terms of having an advantage how many years ago.
The concept keeps being re-marketed through different names adding confusion in the marketplace but in the end there are only two variables that make a difference.
Liposuction results have the greatest variability based on who does the procedure of any plastic surgery operation.
This means that there are plenty of well intended well trained board-certified plastic surgeons with years of experience who have overall good reputations who do not perform liposuction well.
Unfortunately far too many providers see this as a simplistic procedure that has virtually no learning curve. with that attitude providers don’t take ownership of results that are less than stellar and fail to improve in their approach and continue to deliver mediocre results throughout their career.
The number of providers who are truly critical of their own results, recognize how truly steep and long the learning curve is to mastering liposuction treatment and can eventually deliver consistent quality results is relatively small.
Have you mastered Liposuction also means having the ability to make accurate assessments and knowing beforehand exactly what each person‘s result will look like and will be able to demonstrate large numbers of before and after pictures of previous patients with almost identical facial characteristics so patient will have an accurate understanding of what results will look like with high consistency.
Provider selection is absolutely the most important variable when it comes to this procedure.
Liposuction is permanent and irreversible. If done poorly people are left disfigured.
Anybody interested in this procedure needs to first and foremost understand their candidacy for the procedure and with that having a clear understanding of if you should expect quality results or not.
There should be no guessing game with this procedure.
After understanding your assessment you need to vet plastic surgeons and find the most talented and experience provider in your community.
This is labor-intensive and there are no shortcuts.
To find the right provider you need to have multiple in person consultations.
Start by finding which plastic surgeons in your community have the greatest quantity and quality of chin and neck liposuction before and after pictures on their website.
Schedule in person consultations starting with at least five different plastic surgeons.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Being shown a handful of preselected images most likely representing the best results of their career is completely insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they have actually performed.
Ask providers to show you only pictures of people who have similar facial characteristics to your own. This means similar age similar amount of fat, similar bone structure etc. etc.
As providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped.
Ask them specifically what their revision rate and revision policy is.
You should of course confirm that they are board certified by the American Board of plastic surgery or the board of facial plastic surgery.
No other board certification really is appropriate or matters.
When reviewing before and after pictures look very carefully to make sure there are no skin contour irregularities anywhere. Head position can drastically alter what results look like so make sure the before and after pictures are taken in a very consistent manner without head angle manipulation.
For reference and experience surgeon should have no difficulty showing you at least 50 set of before and after pictures of commonly performed procedures like chin and neck liposuction.
Take notes during each consultation about the quality and quantity of before and after pictures shown as well as the overall thoroughness of the consultation including review of medical history, physical examination, assessment, explanation of procedure including alternative procedures, preparation for surgery, recovery etc. etc. etc.
Continue having consultations until you feel very comfortable you found the most talented and experienced provider.
The form of anesthesia is not necessarily that important as long as the provider has experience. Personally I prefer local anesthesia with mild sedation for all liposuction.
Limited areas like chin and neck can be done with local anesthesia only.
Some sedation makes it a little easier for most patients
I cannot emphasize enough the importance of provider selection for this operation. If done poorly results are permanent and results cannot be improved.
The outcome is permanent.
Anybody telling you that their device is superior and that is why you should choose them is a big red flag.
Great results from Liposuction are not device dependent.
It is the skillet an experience of the surgeon that determines the outcome in combination with the patient’s candidacy.
If you’ve only had one consultation I suggest you slow down and schedule at least four more before even considering scheduling surgery.
Do you need to have a clear understanding of your candidacy. A lot of that has to do with age.Older individuals do not do well with Liposuction.
Individuals with lost skin elasticity do not tolerate fat removal because it will compromise their skin.
Laser treatments do not compensate for this.
The best candidates for this procedure are young chubby individuals especially women.
I’ll stop here.
Good luck,
Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!Your plastic surgeon is utilizing an augmented liposuction technique. It is very safe if performed by surgeons specifically trained to perform this procedure. Your voice-box, carotid artery, and jugular vein are safe... When undergoing removal of a "mole" on the chest, one doesn't worry that the heart will be perforated! The plane of dissection is extremely important and is determined by feel and sight (as the overlying skin "tents up" over the cannula). Best wishes with your upcoming procedure...

Robert T. Buchanan, MD (retired) · Answer

You are wise in wondering about the possible complications of submittal liposuction. This area is full of things that should not be injured. Lymph nodes are the least of these, however.. In expert hands, the procedure is quite safe. However, many physicians doing it, particularly with technology like PrecisionTx, are not experts. Therefore, you need to very carefully check the qualifications of whomever you plan to do this.

Could submental liposuction puncture lymph nodes?

Answers (6)

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