WASHINGTON — The removal of fat using ultrasound-assisted lipoplasty may be all it takes to recontour the jowls of younger patients and can complement techniques to recontour the jowls of older and more difficult-to-treat patients, said Dr. James C. Grotting.
Photos courtesy Dr. James C. Grotting
A 34-year-old woman, unsatisfied with the fullness in her cheeks and jowls, is shown before UAL treatment.
Dr. Grotting has been using ultrasound-assisted liposuction (UAL) to recontour the jowls, "especially in the younger round-faced patient - who doesn't require a face lift - and the difficult, older, heavy-jowled patient."
"I think it's important to say that UAL is simply a tool that helps evenly and precisely remove the excess fat that contributes to the formation of the jowls," Dr. Grotting said at the annual meeting of the American Society for Aesthetic Plastic Surgery. "It's my opinion that UAL allows a little more control and may stimulate a modicum of skin retraction." This control helps to minimize the creation of visible lines, furrows, and other irregularities.
Dr. Grotting, a practicing plastic surgeon in Birmingham, Ala., grasps the fat to reposition and observe it to decide if he needs to reduce the amount of fat.
When performing UAL, he doubles the epinephrine injected, and hand-tunnels using the spatulated facial cannula to create the facial plane. Low power ultrasound helps provide additional control. An incision is then made right in front of the earlobe because "if you get behind the ear lobe, sometimes you get behind the platysma and you could potentially damage the mandibular branch," he said.
The patient was still pleased with the results at 3-years postsurgery.
The area to be contoured is just the jowl area, extending down into the neck. "It's important to make sure that you're in the subcutaneous plane," he said.
"I've found this to be a very effective way to treat men - particularly men who are not interested in face lifts." He recommends being more aggressive when contouring the jowls in men because of the thickness of the skin. "I generally will come to the jowl from below."
Dr. Grotting did not have any relevant conflicts to disclose.