Press Articles

Abstract

A review of a new simplified method of liposuction of the neck using a small cannula and syringe is presented. The method does not require high pressure or bulky instrumentation and could easily be done in conjunction with open procedures (e.g., rhymidectomy) or on its own. One can also transfer the aspirated fat directly to any area using a small beveled cannula.

Introduction

In the past few years many techniques have been used in liposuction, with large cannulae and suction machines used for different parts of the body. The morbidity of such instruments is evident. I found using a very small cannula (3-mm gauge plus 5- or 10-cc syringe) can achieve the same result with great ease and comfort to the patient, with the following advantages: simple to use, inexpensive, less traumatic, safer, smaller scar, and fat cells can be directly used for transfer.

Indication

This simple procedure can be used on the face in the submental region or the jowl area separately or in conjunction with open procedures (e.g., facelift or chin implant). It can also be used for fat transfer on the face to complement surgery.

Technique

Preoperative marking is of vital importance, taking care of the surface anatomy of the mandibular branch of the facial nerve.

A small stab wound incision is made in the submental region prior to any open procedures (facelifts, chin implants, and so on). The blunt cannula is introduced with a 5- or 10-cc syringe. The opening of the cannula should be pointing downward. The Tunneling technique is applied as in routine liposuction. The area near the incision should be done first, as the pressure is lost toward the end of the procedure.

Pressure is maintained in the syringe by pulling on the plunger (a special syringe is being designed to maintain the pressure without manual exertion). Fat will be seen to flow through the syringe. Gentle strokes 4 -5 times are initially applied followed by withdrawal of the syringe out of the wound for cleaning in saline. Both the submental region and jowl area can be approached through the same incision.

To make the liposuction even at the end of the procedure, the cannula is rotated until the opening faces upward to sweep the extra fat left behind, while the other hand acts as a guide to assess the amount of fat removed.

The procedure is completed by a criss - cross technique via a separate incision in front of the ear. No drains are required, the wound is closed with Steri-Strips (a stitch is not always neccessary) and draped carefully with 1 inch of Elastoplast, which is left in situ for 1 week. The facelift operation can now proceed.

The same fat can be reintroduced by changing the cannula to a beveled needle with a large bore. This can be applied to all areas for transfer to the chin, cheeks, and so on.

Discussion

I recommend this technique for its simplicity, efficiency, and safety. It has been an integral part in my facelift operations on patients with submental fat. I have performed over 40 cases using this technique in the past year, switching from using the large cannula with high pressure suction to this modified procedure. It is certainly cheaper and easier to maneuver. I highly recommend it.