Submental Liposuction - Frequently Asked Questions
Liposuction is an effective way to remove unwanted fat from under your chin. Patients who complain of loose skin under their neck, a double chin or fullness under the chin can benefit from submental liposuction. Dr Bonaparte will assess all patients interested in submental liposuction at his clinic at The Ottawa Derm Center in Ottawa.
*Disclaimer: the questions below are intended as a guide and to help patients understand their surgery, the surgery risks and typical recovery. It does not replace medical advice or a physical exam by your treating surgeon or doctor. If you have any questions or concerns about your health, please contact Dr Bonaparte or your treating surgeon. This information is not meant in anyway to provide medical advice or guarantees for surgery.
Common Submental Liposuction Questions
What is Liposuction?
Do you need to be put to sleep for liposuction?
I have a double chin and fat or fullness under my chin, will liposuction fix this?
What Happens if I gain weight after liposuction?
What will happen to the loose skin under my neck after liposuction?
Will losing weight improve my submental fat or the fat under my chin?
How does liposuction surgery differ from Belkyra® and Coolsculpting®?
What are different Types of Liposuction?
Will liposuction tighten the loose skin of my neck?
Where are the incisions for a submental liposuction?
How long does it take to heal from liposuction?
Are there scars from liposuction?
What are the complications from liposuction?
What is Liposuction?
Liposuction is a procedure that can remove unwanted fat in your body. Dr Bonaparte offers treatment for submental fat and fullness. Many people call this problem a ‘double-chin.’ Submental fat appears under your chin and often creates a look that appears like a pocket of sagging skin under your chin. This fatty tissue can make your neck look loose, hanging and even reduce the angle of your jaw.
There are different methods to perform liposuction but the most common is what we call power assisted liposuction. Patients who undergo liposuction are almost always sedated and, in many cases, put fully to sleep. Once you are asleep the procedure is performed. Typically 3 very small incisions are required.
Using the liposuction device, your surgeon will carefully move the canula (this is the name of the device inserted under your skin) in a back and forth manner. This breaks apart the fat and sucks it out, hence, Lipo (Fat) + Suction.
Do you need to be put to sleep for liposuction?
This is a common question we get asked. The answer is that it depends. There are a few challenges when performing liposuction and choosing the right type of anesthesia can improve the safety of your surgery. Here in Ottawa, we have different options to perform submental liposuction.
There are really 4 ways surgeons perform submental liposuction anesthesia:
1) Local Anesthesia only – This is one I do not recommend. This involves freezing only, similar to freezing you get at the dentist. The problem is that the experience can be traumatic as you are fully aware. Also, because you are not receiving pain medication through an IV, there is a risk of toxicity from the freezing you get. A doctor would have to inject far too much freezing to keep you comfortable, so I do not recommend this and I personally, would not perform the procedure using this method.
2) Conscious Sedation – This is one of the most common methods to keep you comfortable. Using a combination of anti-anxiety medication and anti-pain medication, your surgeon and nurse can keep you calm and comfortable during the procedure, yet you are still awake and can respond to basic commands. You may not remember the procedure, but you can often talk. The benefits of this method, is that patients feel back to normal more quickly after the procedure. The downside is that because you can move, it often takes longer to perform the procedure. In addition to this, sometimes you may react too strongly to the medication and stop breathing for brief periods. This requires the nurse and doctor to help you breath until the medication wears off. This can increase the total surgery time.
3) Total IV Anesthesia – This method is similar to Conscious sedation however patients are more sedated. During the procedure you receive a constant low dose of anesthesia to keep you sleepy and unaware. In Conscious Sedation, we usually give you a dose of medication and wait till it wears off then give another one. With IV Anesthesia, you receive a constant ‘drip’ of low dose medication to keep you sedated. The risks and benefits are similar to conscious sedation.
4) General Anesthesia – I tend to prefer general anesthesia for my patients when they undergo submental liposuction. This involves being fully asleep with an anesthesiologist present. The benefit is that we can keep you from moving around and we know you are always getting oxygen. This helps make the surgery time shorter. In addition to this, it is easier to keep your blood pressure controlled so there is less bleeding. The downside is that you may feel more nausea after surgery and some muscle pain.
There are lots of options. If a patient asks for sedation versus general anesthesia, this is certainly something we can do.
I have fat or fullness under my chin, will liposuction fix this?
Submental fat or fat under the chin is one of the most common reasons people seek a consultation. People find this makes their neck look saggy and results in a poorly defined jaw angle when looking from the side. Even after people lose weight, people find the submental area doesn’t improve. This creates a situation where people seek treatment. Liposuction is designed to improve this safely and effectively.
What Happens if I gain weight after liposuction?
Liposuction is a permanent treatment. We are all born with fat cells in our body and once these are removed, they typically do not grow back. Fat cells get bigger and expand as they store fat. Under the chin, many people find weight loss doesn’t improve the area as much as they would like. Liposuction removes the fat cells and thus, most people find even if you gain weight again, not as much will show up under your chin.
What will happen to the loose skin under my neck after liposuction?
Many people are concerned that if we remove the fat they will have loose skin. This is not necessarily true. One of the best predictors for this is the tightness of your skin before the treatment. If you perform the liposuction and have tight, younger skin, almost always the skin will remain tight and look fantastic. There are three factors that often contribute to having a higher risk of loose skin after liposuction:
(1) Increasing age
(2) More sun exposure
(3) Looser the skin before liposuction
However, this is not the full story. Performing liposuction results in some inflammation under and within the skin. This inflammation results in remodeling of the collagen and elastin in your skin. The majority of patients also notice an increase in tightness after liposuction. This effect can take up to 6 months after surgery. I have many patients who thought they required a neck lift but we performed liposuction and they had excellent results.
The good news is that if the skin does not tighten, there are laser treatments and other non-surgery treatments we can do to improve this after your surgery. This is something we discuss during our consultation and surgery planning.
Will losing weight improve my submental fat or the fat under my chin?
Even though there are many health benefits of losing weight, many people find the fatty tissue under your chin doesn’t improve as much as you would have liked. In these situations, people often seek out treatment. Submental fat is somewhat different than fat around your belly, it usually doesn’t go away with weight loss. You may find your neck looks better after losing weight, but true submental fat may not go away.
How does liposuction surgery differ from Belkyra® and Coolsculpting®?
There are three primary methods doctors use to reduce fat under your chin, Liposuction, injection of a medication called deoxycholic acid (Belkyra®) and using targeted cold therapy such as Coolsculpting. I have seen each used and have spoken to many patients who tried both the injection as well as the cold treatment. The non-surgical methods are good options if someone does not want surgery, however I do believe that liposuction remains the gold standard and is the most reliable treatment option. My concern about both cold and the injection methods are that they are less predictable, they also carry risk after treatment and we still do not know the long term risks. In my experience, I get far better results with surgical liposuction. I have seen over 20 patients who failed treatment with both of these other methods and liposuction resolved their concerns in one treatment.
With liposuction, the doctor can feel the fat as we remove it. We know when it is gone, and we know when to stop. With other treatments, this option doesn’t exist as you must trust the process and hope it works.
That is why for me, liposuction is the most effective means to accomplish fat removal from under your chin.
What are different Types of Liposuction?
There are two main types of liposuction I use for patients. Traditional manual liposuction and power assisted liposuction. Manual liposuction is a tool that is hooked up to suction and the surgeon moves back and forth to remove fat. Power assisted liposuction utilizes a special device that vibrates the end of the liposuction cannula and allows better removal of the fat. I typically use both types during the surgery.
Dr Bonaparte performs submental liposuction in the Carleton Place Hospital just outside the city of Ottawa. I utilize a modern liposuction set-up that is also used for body liposuction.
Will liposuction tighten the loose skin of my neck?
Before and After images of a patient of Dr Bonaparte who had submental liposuction. This patient had loose skin under the neck as well as some fatty tissue. The procedure resulted in an excellent tightening effect of the skin
This is a bit more of a controversial topic, however, the answer is that it depends. Younger patients or patients with healthy skin (for example, skin that is not sun damaged) will often notice considerable tightening after liposuction. During liposuction, the procedure causes inflammation of the skin which over the course of 6 months can result in collagen and elastic rearranging within the skin. This results in tighter skin. I have had many patients who assumed they required a neck lift but liposuction alone achieved the results they expected. Not everyone benefits from this. I typically perform a full exam to determine if someone is at risk of loose skin after liposuction. If that is the case, I will recommend post-treatment non-surgical options like Thermage or Ultherapy.
Where are the incisions for a submental liposuction?
There are three small incisions for submental liposuction. One 2mm incision behind each earlobe. One 2mm incision under your chin. Nearly all patients heal without any concerning scars.
How long does it take to heal from liposuction?
It is challenging to pick an exact time that a person heals, but below is a general guide for the average patient. All patients are seen 1 week after submental liposuction at my Ottawa Clinic at The Ottawa Derm Center.
After surgery, patients usually feel mild pain and tightness, this can last 3-5 days.
Days 1- 7: Swelling, Mild pain and you will be wearing a tensor bandage 24 hours a day apart from showers and cleaning. Although there is swelling, it is usually significantly less than when using injection methods to treat the fat under your chin.
Days 7-14: Patients usually feel much better, less pain and tightness and many people can get back to work. We ask that people wear the tension dressing as much as possible during this time. Some choose to wear it another week 24 hours a day, but we advise people it’s ok to remove it for walking and getting out of the house.
Month 1: Most patients look great at 1 month but there is still some swelling under the chin that would be considered mild. There may still be some loose skin. Overall, most people look close to back to normal.
Month 6: All the swelling should be gone and people should have achieved tightening of the skin
Are there scars from liposuction?
There are three scars from liposuction, a 2mm one behind each earlobe and a 2mm scar under the chin
What are the complications from liposuction?
Like all medical and surgical procedures there are potential risks. Minor risks including the scaring, tightness of the neck and swelling post surgery. More rare but serious risks include more significant scars, bleeding under the skin and damage to the facial nerve. The facial nerve is a critical nerve that controls the motion of your face. It is common to have swelling around the nerve after surgery that can result in a short term effect on this nerve. This may result in some weakness when moving your lip. Permanent damage to this nerve is rare but is a risk of liposuction.
My staff here in Ottawa will contact you the day after your submental liposuction surgery and we will get you in for your follow up 1 week after surgery. The OR nurses will also contact you the day after surgery to ensure you have no concerns. Your safety is our number one priority and we will maintain communication during your early post-op days to ensure everything is healing as expected.