The method of fat removal by suction was used by Professor Sailer in maxillofacial surgery more than 15 years ago during his work at the University of Zurich Hospitals.

A better term in the facial area would be “fat reduction”, not fat removal, although that describes the technical process exactly; better yet, a modellation of the surface of the face. In the facial area the emphasis is more on the prominent facial contours in the foreground. This can occur through the removal of the smallest amounts of fat, for example, on the edge of the lower jaw, as compared with the quantitatively rather large fat reduction on the trunk of the body. Several specialties share these readily accessible body areas today. I do not wish to take a position on that, although, of course, we frequently perform fat reductions by means of liposuction on other parts of the body. Procedures in the facial area should, in any case, be left to facial surgeons. Fat accumulations in the face are often right next to important anatomical structures, of which one must have precise knowledge in order to protect them safely. Also the technique of suctioning fat in the facial area is subject to some special considerations, for example, ensuring regular breathing. The method of liposuction in the facial area is used most frequently for contouring the neck region. The “double chin” or the “fatty neck” is to be reduced. The contour of the edge of the lower jaw should become visible once again. We have also used this method for the reduction of the soft tissue parts of the cheeks, jowls, or also for contouring soft tissue areas with asymmetry of the face. Although only the smallest amounts of fat are removed for the most part, this procedure must be performed very carefully, on the one hand, in order not to damage anatomically adjacent structures, on the other hand, in order to avoid irregularities. These are tolerated far less in the facial area than in other places where the body areas are covered.

In order to achieve a perfect result, the oral-maxillofacial surgeon must be able to work on the patient without being disturbed. For that reason, we perform this procedure only in twilight sleep or under short-acting anaesthesia (sedation) so that the patient is not endangered by unintentional movement. A tumescent anaesthetic fluid that is infiltrated under the skin facilitates the removal of fat tissue. Today the removal takes place with the smallest, only 2mm wide cannulas. The injection sites are concealed at the hairline behind the ears, under the chin or in natural folds. A bandage should be worn then for a few weeks so that the skin, primarily in the chin/neck area of the new surface, can attach itself well.