Face and Neck

Fat Accumulation occur in the Neck and Lower Face due to three main reasons:

• Hereditary:  Some people have genetic potential to accumulate fat in the face and neck region in spite of good weight control.
• Weight Gain: This is the commonest cause of fat accumulation in the face and neck areas

• Aging:  As age advances we start accumulating fat in the jaw line and neck changing the shape of the face. Face becomes wider and we develop double chin deformity

Let’s first understand what happens in different parts of the face:

• Upper face: we often loose fat and bony volume in this area. There is temporal hollowing and under eye hollowing.

• Mid face:  we lose fat and bone volume in the cheek areas, on the other hand there is prominent nasolabial bulge due to displacement of fat and skin sagging. In overweight patient there is chubbiness of cheeks with increase in Buccal fat pad and subcutaneous fat.

• Lower face:  This undergoes maximum changes. In overweight people the fat is accumulated in the angle of the jaw, jaw line, chin and neck areas. Whereas aging changes are due to displacement of fat from mid face to the jaw line. At the same time the fat accumulates and jaw line disappears.The shape of the face changes as we grow older and it becomes wide, pear shaped or square shaped.

Facial restructuring is a minimal invasive approach to restore the face and neck contour.What are the options for the face and neck reshaping And what is facial restructuring?

• Upper face:  Volume restorationVolume restoration of upper face can be done by using Filler material or Micro fat grafting using autologous fat (body’s own fat).Micro fat grafting uses your own fat that is removed by micro liposuction process. The fat is than centrifuged to separate blood, liquid and fat cells. The fat cells are enriched using Platelet rich plasma that has several growth factors increasing the survivability of fat cells.The fat is then grafted using classical Coleman technique using small syringe and cannula. The procedure is performed under local anaesthesia.The areas that are grafted includes
  1. temporal areas
  2. brow
  3. upper eyelid if there is hollowing
  4. under eye or peri orbital areas

• Mid face:  Volume enhancementThis is also called as liquid face lift. Microfat grafting is performed to fill up the following areas
  1. Malar area
  2. Preauricular area and
  3. Cheeks

• Volume reduction: Volume reduction may also be necessary if there is excess fat in the face changing the shape of face. The fat accumulation occurs in:
  • Preauricular – fat accumulation in front of the ear makes the face round and wide
  • Buccal- It can be in two places
    1. Internal fat in this area is called buccal pad of fat
    2. External fat is under the skin and is called as subcutaneous fat.
  • Nasolabial area

• Lower Face and Neck– Volume reductionThe main problem in this area is fat accumulation that occurs in following facial units
  1. Mastoid area – accumulation of fat in the lower part and behind the ears makes the face wider
  2. Jaw line – This fat masks the mandibular bone
  3. Submandibular- The fat fills up the space and jaw line is disappeared
  4. Sub mental- Fat under the chin causes double chin

The fat under the skin or external fat can be removed by micro liposuction technique.

What is the technique of facial restructuring?

It is a combination of procedure where excess fat is reomoved from some part of the face and reinjected in other part to restore balance and youthfulness.Whereas

Facial Liposculpturing is the procedure where fat is removed from all the units of the face as described above.Procedure is performed under local anesthesia, two small incisions are made near the ear lobe on each side and one under the chin.Infiltration fluid containing lidocaine and adrenaline are injected in the fatty layers.

Laser or Vaser can be used to perform fat emulsification. Following that a small cannula is inserted and fat is suctioned out thus contouring the face

What is after care and recovery?

Patient is advised to wear a pressure garment continuously for two days. This is followed by wearing garment for at least 12 hours a day for ten days. They can return to work in three to four days time depending upon bruising and swelling.

What are the risks of face restructuring?

The risks are haematoma, skin unevenness, asymmetry, facial nerve damage etc.
These are extremely rare in our centre.