Vitaly Igumnov Aleksandrovich: Lipomodelling of the Lower Third of the Face and Neck using Laser-assisted Liposuction

The presence of excess subcutaneous fat in the lower third of the face increases age-related changes and provokes further ptosis of soft tissues. Currently, there are various methods of surgical correction of these changes, with a high degree of traumatization (lifting of the frontal and lateral parts of the neck, platysmaplasty, lifting of the lower third of the face) as well as minimally invasive methods (radio wave, ultrasound and laser liposuction).

The majority of patients prefer minimally invasive methods, since these methods do not require a significant examination, are mainly performed under local anaesthesia and are followed by a short rehabilitation period. We use laser liposuction to correct excess fat deposits in the lower third of the face. This choice is due to a number of advantages. These include retraction of the skin due to the formation of new collagen, reduction of intraoperative and postoperative bleeding, as well as reduction of the adipocyte population. All patients received a lasting aesthetic result.

A significant number of patients and the duration of observation allows us to argue for the use of Nd:YAG laser irradiation with a wavelength of 1,064 nm. It’s effects on adipose tissue in the lower third of the face and the submental area allow coagulation of the vessels and capillaries, which minimizes intraoperative and postoperative bleeding and the formation of hematomas, which help to reduce the duration of the postoperative rehabilitation period. Also, after removing the fatty detritus of emulsified adipocytes from the liposuction zone, the dermis is heated in the liposuction zone to 39-40 °С using the optical cannula. Due to this, collagen fibers are compacted, elastin is stimulated and new collagen is produced, and as a result, a substantial uniform reduction and retraction of the skin in the area of ​​impact is achieved, including the areas with reduced dermal turgor. This leads to a higher skin tightening effect in the area of surgical exposure. Thanks to laser liposuction, we not only remove the excess volume of adipose tissue, but also achieve lifting of soft tissues due to the stimulation of neocollagenesis and restructuring of collagen fibers.

In our opinion, laser liposuction, when used for the correction of the lower third of the face during the deformation aging type, allows for the correction of excess volumes in the lower third of the face and submental area with simultaneous retraction of soft tissues, which leads to a harmonious result that restores a clear neck-chin angle and contours of the lower jaw.

The advantages of this method are the following: the speed of the operation, local anesthesia, the absence of postoperative scars and pain, a short period of rehabilitation and the visible effect. The resulting effect is prolonged and does not require correction.

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