General principles of liposuction on the face and neck

Local obesity can be attributed to hereditary factors, hormonal imbalance, improper diet and lack of physical activity. Evenly distributed body fat deposits, in contrast to isolated fat deposits on the face, can be corrected by diet and exercise. Unfortunately, often local deposits of fat are the first signs that require paying increased attention to weight gain.

An extensive study of the physiology of the adipocyte was carried out by Illouz, who is one of the pioneers of li-planting. He found that the number of human adipocytes increases from the moment of birth to the puberty period, in the future it stabilizes. Based on histological studies, he found that obese children are characterized by a large number of adipocytes (hyperplastic obesity), and for obese adults - "large" adipocytes (hypertrophic state). Their volume increases due to the accumulation of triglycerides and fatty acids. Therefore, weight loss is a reduction not in the number of fat cells, but in their volume. Ideally, surgical intervention should be aimed at the irreversible removal of fat cells from their accumulation sites. The main goal and purpose of vacuum lipectomy is to recreate aesthetic outlines by removing unattractive fat deposits.

The majority of new technological implementations, with one exception, originate from studies on changing the shape of the body, which often find applications in facial surgery. The use of rigid, blunt suction cannulae attached to the suction device continues to be the main direction of vacuum lipectomy.

Unobtrusive incisions for liposuction on the face and neck can be located in the sub-chin, the bovine fold, the nose and in the area of hair growth in the temple. Restoration of the contours of the skin is achieved by removing torn off fat cells, followed by a decrease in the thickness of the subcutaneous tissue during the healing process. Fat cells are mobilized using the technique of hypotonic infiltration, under the influence of ultrasound or by simple mechanical tearing.

In comparison with direct lipectomy, traditional liposuction allows for a relatively accurate reduction in the mass of fat cells with a relatively smaller number of complications. Since liposuction leads to vascular bundles in the skin, there is less bleeding and a decrease in the amount of hematoma. The disadvantage of liposuction is incomplete removal of deep fat in the middle part of the sub-chin, which often requires a direct median incision. Restoration of contours occurs as the healing and reduction of the network of subcutaneous tunnels, created with the use of tunneling technique of liposuction. A carefully designed and evenly distributed tunnel system rarely results in the recurrence of bulges and irregularities caused by local fat deposits. In the early period of healing, irregularities can be observed, which are usually temporary.

Aspiration lipectomy has several advantages in comparison with techniques designed for direct fat excision. With such a lipectomy, there is no need for large incisions, the duration of the operation and the recovery period is shortened, as well as irreversible damage to the nerves. Aspiration lylectomy due to tissue tunneling allows you to keep the neurovascular bundles to the skin. Preservation of innervation means less numbness in the skin. To achieve perfect aesthetic results, which bring joy to the patient, will allow selection for the procedure of patients with elastic skin and local fat deposits, as well as the use of suitable operating and postoperative techniques.

This section is a guide to the selection of suitable candidates for liposuction. It provides an overview of the physiological basis and technique of liposuction, describes the necessary equipment and suggests ways to prevent complications. Finally, the most advanced achievements in this field are discussed.

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