Possible Short-term and Long-term Side Effects of Facial Liposculpture

I am interested in facial liposuction to sculpt my lower cheeks. There is very little information available on this procedure, but I understand that in the shorter term, it may actually tighten the skin as the scar tissue contracts during the healing process. I am wondering what the long-term side effects are on skin laxity or the possible ramifications on aging facial tissue. I am 32, Asian/Irish, with pale and delicate skin that is prone to broken /dilated capillaries. Is this procedure generally recommended for someone with thin, delicate skin? What are the possible short-term and long-term side effects of this procedure?

Doctor Answers 18

Skin tightening

This issue of skin tightening after liposuction treatment is something that there is a bit of a buzz about right now. There are several techniques that claim increased skin tightening in addition to fat removal. They include laser liposuction (or liposculpting), ultrasonic liposuction, etc.

The difference is that in addition to removing unwanted fat there is energy delivered to the dermis (the deeper layers of your skin) and the collagen (one of the main structural proteins that makes up your skin) remodels (tightens). There's pretty good evidence that this can make small differences in skin excess.

The key is that the skin tightening will not be as dramatic (and some claim not as long lasting) as more traditional skin tightening procedures (facelift, mini-facelift). At 32 you probably don't have much excess skin though.

I hope this helps!

Liposuction generally is no longer done on the "face"

There once was a time when liposuction was done to the cheeks of patients whose cheeks were chubby. This is no longer done after the experience with these previous patients. Liposuction is generally confined to the jawline and neck and in these regions, works best in younger patients whose skin might shrink better than older patients.

The reason that liposuction didn't work well in the cheeks is anatomical. There isn't much distance between the skin, the fat, the underlying facial muscles, and the nerves that run the muscles. In order not to injure the nerves, liposuction needs to be kept closer to the skin, far away from the nerves. When you liposuction too close to the skin, you will see grooves and ridges that are permanent and impossible to eliminate.

So, liposuction above the jawline isn't a good idea.

Facial Liposculpture: A Risky Approach

While I routinely use liposuction to remove fat under the chin and around the neck, I would not recommend it to slim and contour the face. There is far too much risk of nerve damage, and there are safer ways to restore youthful contour to the cheeks and face. I’m specifically thinking of Venus Legacy, a non-surgical protocol for fat removal, skin tightening, and body contouring. It is effective for toning and tightening the face as well as any areas of the body prone to fatty deposits. I’d suggest you ask your cosmetic surgeon about it to achieve a noticeable improvement in your appearance.

Hal Michael Bass, MD
Miami Plastic Surgeon
4.5 out of 5 stars 46 reviews

Liposuction of the cheeks

In general liposuction of the cheeks in not performed except in rare cases. The facial nerve runs in this area and is at risk.  Some people have a large buccal fat pad in the lower cheek that can have a prominence in some patients.  This can be partially removed with a simple procedure with an incision in the mouth.  the jowl area if this is considered the lower cheek is amenable to a minor amount of liposuction, but should probably be combined with fat grafting to the jawline just in front of the jowl to help the jawline contour.  As other surgeons have pointed out the face does narrow or hollow out in the cheeks and marionette lines.  These may also need volume with fat grafting, sculptra, or other fillers.

Scott Haupt, MD
Salt Lake City Plastic Surgeon
4.5 out of 5 stars 12 reviews

Effects of facial liposculpture

  It is difficult to say if this procedure would be right for you without seeing photos but I think it likely would not give you the results you are seeking.  Also, I agree with another physician who responded that the tightening effects that you are seeking are variable.  Yes, it does happen but not in every casae and possibly not to the extent that you are seeking.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
5.0 out of 5 stars 110 reviews

Facial Sculpting and Liposuction

Liposuction in the cheeks is by no means a standard procedure as it has been in the past.  I sometimes combine liposuction with facelifts for gentle contouring.  There are other ways to change the width of your face and a consultation in your case is really crucial to understanding your face and making recommendations.  I would definitely explore other options before settling with facial liposuction as a stand alone procedure.  Good luck!

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.5 out of 5 stars 38 reviews

Caution in performing facial liposuciton

Generally speaking excess fat is not a hallmark of aging, rather the loss and absence of fat is more typical of aging. Therefore we tend to prefer to reposition or add fat to the aging face. The short term and long term effects relate to the agressiveness of the treatment. But other than conservative liposuction of the jowls as an adjunct to a face lift, very little fat is removed. Commonly we add more fat. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 72 reviews

Liposculpture of the face has special risks of aging

As humans age our faces narrow and become longer and cheeks thin and droop. People with narrow faces and sunken cheeks frequently are judged to be ill or old. Liposculpture of the face may initially look good but cause faster aging subsequently. As with any advice there are plenty of exceptions for whom liposculpture may be appropriate such as in treating jowls.

Edward Lack, MD
Chicago Dermatologist
3.0 out of 5 stars 5 reviews

Facial Liposculpture for the Cheeks

The use of facial Liposculpture is valuable if done selectively.

Liposuction of the face can be problematic if overdone or applied inappropriately.

The "tightening effect" to which you refer is more theoretical than proven. The value and longevity of using laser in combination with facial Liposculpture is subject to disagreement by experts in the field.

To help you decide what's best for you, consult with well trained, well reputed and experienced board certified plastic surgeons.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 28 reviews

Facial liposuction

It would depend on your anatomy.  If you have good elasticity going in, it will likely remain, but based on what you are saying, you will likely have some excessive bruising.   I personally dont believe lipo adversely affects skin laxity.  I also dont believe that fillers lift anything, but instead radially expand to create the illusion of lifting.

Dr. Malouf

Peter Malouf, DO
Dallas Dermatologist
4.5 out of 5 stars 84 reviews

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.