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Complications after liposuction on the face and neck
Last reviewed: 08.07.2025
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As a rule, unlike the potentially dangerous complications of liposuction on the whole body, the main complications of liposuction on the face and neck are minor and temporary disturbances. Unlike operations on the body, where large volumes of fat removal can lead to volume disturbances and blood loss, liposuction on the face and neck rarely affects hemodynamics. As noted earlier, the volume of fat removed usually ranges from 10 to 100 cm3.
Infectious complications are rare and occur in less than 1% of patients. Postoperative antibiotic therapy is not required, but most surgeons in private practice administer at least one intravenous antibiotic during surgery. When liposuction is the primary procedure, hematomas, seromas, or sialoceles also occur in less than 1% of patients. Sialoceles are more common after liposuction over the parotid bed; treatment may require compression, anticholinergics, or drainage. When liposuction is used as an adjunctive procedure, fluid collections may be due to a more aggressive procedure such as rhytidectomy. Fluid collections are usually effectively removed by needle biopsy or by expression through the incision line.
Long-term problems may manifest as loose skin or scarring. Excessive loose skin may be due to poor patient selection or unpredictable senile or pre-senile changes and may require rhytidectomy. Scarring may be due to poor healing, poor surgical technique, or infection. Problems may be due to excessive thinning of the subcutaneous layer or improper orientation of the cannula lumen. Options for correcting skin scarring are limited.
Uneven aspiration may result in asymmetry, but this occurs less frequently as surgical experience increases. Minor corrective liposuction can be performed in the office under local anesthesia using a small cannula and syringe. Problem areas too small for liposuction can be carefully injected with 0.1-0.2 cc of triamcinolone acetate (10 mg/ml) at 4-6 week intervals. Higher doses or too frequent injections may result in thinning, retraction of the skin, and spider telangiectasias.
Minor localized postoperative tissue depressions usually require the use of fillers. Collagen or autologous fat may be effective for this purpose, but is usually only a temporary solution. Larger tissue deficits may require synthetic materials such as cheek subzygomatic implants or dermal grafts such as acellular dermal grafts (AlloDerm). Of course, prevention is the best treatment, and this cannot be emphasized enough. Injury to the marginal mandibular branch of the facial nerve is rare, as is the occurrence of secondary hyperesthesia associated with trauma to the greater auricular nerve. If paresis, paresthesia, or paralysis does develop, it is almost always short-lived and resolves over time.
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