How Risky is Jowl Liposuction?

I had Chin Liposuction in August. Fat was removed under my chin, not the jaw line. My face looks larger now as my jowls are still round, while my chin is more defined.

My surgeon didn’t touch the jowls because of too small amount of fat and risk of nerve damage. I have found another surgeon who says she can remove the jowl fat with P.A.L. (Power Assisted Liposuction).

She said nerve damage is extremely rare; potentially a nerve can get squeezed and temporary affect the face, but since the cannula is round, it is impossible to cut a nerve. Is this true?

Doctor Answers 13

Risks of chin and jaw liposuction

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I love this question because I think the risks of this procedure can be a little understated at times.

Essentially what you're surgeons have told your true. There is risk of nerve damage though it is slight. However, most providers now will use some laser assisted technology such as SLimLipo or Smartlipo. What is that mean? It means that the nerves and muscles of the jowl and corner of mouth are it slightly increased risk. So can you have some with weakness or nerve damage that could last weeks to months after this procedure? You absolutely can. I've seen it another patient's father offices and I've seen it in my own patients. I Mark the patient's anatomy and jowl preoperatively and deliberate effort to avoid those specific spots where nerves are crossing but also treat the jowl and other problem areas as effectively as I can. What I explained to the patient's is is that we can be more aggressive and treat more the face but with increased risk to a temporary impairment or damage to some of the nerves providing muscular movement of the mouth and lips. This usually is pretty slight and other people do not notice it but use the patient certainly do. If you're willing to take that risk and deal with a week corner of the mouth or lower lip for a number of weeks and possibly months they need generally can get a better improvement. It's always a trade-off. That being said I still treat patients with this technology as aggressively as I can within the boundaries of safety but if the patient and I have have that conversation about the risks and they want as much as they can without actually having a facelift then I would say 10% of the time patients have some temporary weakness of at least one side of the lower lip. I've never had any permanent issues but I like it that you've asked this question because again I feel like chin and jaw life of section is described as a procedure that is without risk and that is not true.


I hope that is helpful

Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Liposuction of the jowel

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Liposuction in the jowel area is definitely higher risk for nerve injury - especially PAL.  Sometimes there is temporary nerve injury from inflammation or stretching of the nerve. However, if you have a lot of hanging tissue or fullness in the jowel area, you may need a facelift to pull and tighten this area - it's impossible to say what procedure you need without examining you.  In general, I recommend you go to an experienced surgeon who has performed liposuction in this area.  They will be able to discuss the risks, benefits, and alternatives to helping you create the appearance you desire.


Dr. Cat Begovic M.D.

Facial nerve injury is a risk of jowl liposuction

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While standard or laser Assisted liposuction is safe in the neck area, great care must be exercised when attempting liposuction in the jowl area.

The Marginal Mandibular Branch of the Facial Nerve runs near the surface of the skin unprotected by the SMAS or Platysma Muscle just below the corner of the mouth in the Pre-Jowl Sulchus just in front of the jowl.

If the Margiunal Mandibular Nerve is injured muscles which hold the corner of the mouth in position are paralyzed creating a very visible and catastrophic deformity of the mouth. The smile can be grossly distorted following this nerve injury and the deformity is usually permanent.

Board Certified Plastic Surgeons are trained to understand the location of this nerve and avoid it during facelift procedures.

Liposuction in the jowl area subjects this nerve to risk of injury.

Unfortunately many doctors who are attempting facial liposuction are not board certified plastic surgeons and many are unaware of facial nerve anatomy and the risk of Marginal Mandibular Nerve Injury.

If you are considering liposuction in the Jowl area be certain to see a Board Certified Plastic Surgeon and ask him/her what streps they will take to avoid injury to the Marginal Mandibular Nerve.

Detailed anatomic drawings of this nerve are available in my Book Facial Danger Zones.

Jowl liposuction is effective and safe

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Liposuction of the jowl is a safe and effective procedure that can be performed under local anesthesia in an office setting, with or without minimal oral sedation. The scars are well concealed and minimized by placing them just behind the base of the earlobe. Regardless of the technique utilized (traditional, VASER, laser-lipolysis, power-assisted), I found that with efficient superwet local anesthesia, patients experience minimal bruising and tenderness.

However, patients should expect swelling that may persist anywhere from two to four weeks. Patients are encouraged to massage several times daily. Nerve injury is exceedingly uncommon with good surgical technique and anatomic knowledge. I would agree that nerve transection is difficult, but not impossible. Nerve injury or neuropraxia can result from the liposuction instrument or post-operative swelling, but invariably returns anywhere from days to weeks after the procedure.

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon

Jowl liposuction

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The jowl area is often the site of fat pad accumulation and commonly relates to a drifting of the actual cheek pad 'downwards' to the jawline. The jowl pad can be liposculpted IF the overlying tissue is not overly lax/loose due to aging changes. Otherwise, it is safe IF the cannulas are kept close to the skin and above the muscle/platysma. There is also a 'ligament' nearby which can lead to dimpling or a misdirection of the cannula, if the surgeon is less experienced. Generally, it can be done

Gerald Wittenberg, MSc, DMD
Vancouver Oral & Maxillofacial Surgeon
5.0 out of 5 stars 29 reviews

Risks associated with jowl liposuction

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It is not impossible to cut the nerve during liposuction of the jowl area but in the hands of an experienced surgeon the risk is relatively low.  I have been seeing an increasing number of complications due to laser-assisted liposuction probably due to the surgeon not moving the laser fiber fast enough and letting it dwell in a certain area too long which causes burns to the skin.  It's important to know that any procedure is only as good as the surgeon performing it so it's important to ask your surgeon how many cases they've performed and how many if any complications they've had and how they dealt with these and what were the outcomes.

M. Christine Lee, MD
Walnut Creek Dermatologic Surgeon

Jowl Liposuction safety

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Nothing is impossible. There are risks with anything and everything. However, when carefully performed, in good hands, complications from jowl Liposuction are extremely rare. It is important that the liposuction be superficial to the underlying musculature. In general, I performed jowl liposuction in conjunction with liposuction of the neck when appropriately indicated. I may also perform this liposuction in conjunction with a face/neck lift procedure.

Jowl Liposuction

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When done properly by a highly skilled surgeon, risks will be minimized when performing jowl liposuction. But there is still risk of nerve damagae with any liposuction of the face. And I would not recommend power assisted liposuction to the face. I would really need to see photos to give you the best advice. If you wish, you may send me any photos and I would be happy to give you my opinion on whether or not you would be a candidate for liposuction of the jowls. My contact info is listed in my profile. Thank you and best of luck.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Neck and jowls liposuction

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Liposuction of the chin and Jowls can be done fairly safe. Temporary nerve problems can occur due to swelling, bleeding around the nerve cheek chin interface but usually this subsides fairly soon.

On the other hand if your cheeks and jowls have extra skin (not just fat!) you may need a face lift to correct the "square appearance" of your face.

As mentioned by the other surgeons ask for an experienced Plastic Surgeon and than ask him/her the question if liposuction alone will do the job.

Thanks for your inquiry and good luck!

Guido P. Gutter, MD
Evansville Plastic Surgeon
4.9 out of 5 stars 18 reviews

Safety and Effectiveness of Chin or Jowl Liposuction

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I perform the chin and jowl area all the time. There is always risks with any form of surgery but it really depends on the physicians experience. Do your homework. How long has the physician been doing these procedures? How many were the chin/jowl area? Can you see some before and after photos?

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 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.