Facial Lipomodelling for men

Lipomodelling is a cosmetic facial surgery procedure that balances the volume and shape of the face and neck by removing fat by liposuction; this tends to accumulate around the jowls and double chin. Also, the technique replenishes tissues that have emptied or sagged (cheekbones, dark circles, lips, ...) by injecting your own fatty tissue (lipofilling).

Each face is unique, has its own character, expresses emotions and feelings and gives individuals their personality. It is not a question of modifying the identity of the face but of harmonising the curves and volumes. For this reason, my priority is to preserve the natural appearance of your original face and personality.

Your social circle will notice a change and an improvement but without being able to identify that it is due to an operation. Very often, they will put it down to a week’s holiday.

Lipomodelling can be used for two types of patients with different objectives:

• Face refining surgery using liposuction in young patients who have fatty excesses, such as a double chin, jowls, fatty cheekbones…

Localised fat in the cheeks is known as the "Bichat ball" located deep within the cheek. It gives an impression of bloated cheeks and masks the cheekbones and chin, giving the look of a baby face. Then, when it collapses, the jowls become prominent.

• Surgery to prevent facial ageing by maintaining tissue volume (lipofilling) to prevent sagging and wrinkle formation on tissues that tend to empty with age.

In men, the fatty area most often treated is the double chin as sagging skin in this area is generally associated with a fatty excess overload. In this case, as well as performing liposuction, it is useful to enhance the skin by inserting a deep tension wire (cervical curl-lift ). This considerably improves the result without scarring.

Each person comes to me asking for a particular defect to be corrected when they find this particularly troublesome. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects for a well-balanced, natural result that meets your expectations.

So, depending on the insights gained during the first consultation, the operation may be combined with another operation to improve the overall harmony of the face. Indeed, correcting a particular defect sometimes risks bringing out another defect that was less visible before. This can be carried out during the same procedure or at another time

So, lipomodelling can be carried out on one or more areas of the face and neck by using liposuction of fat deposits and lipofilling of areas that have sagged.

Lipomodelling can be performed along with:

• Eyelid plastic surgery,

• A frontal, temporal, malar, cheek or cervical curl-lift using tension wires,

• A lifting technique,

• Hyaluronic acid or botox injections to reduce areas of wrinkles,

• Chemical or laser peels.

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations, which are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the natural aspect of your appearance.

So you can visualise the desired result, using a mirror, I will manually recreate the effect the recommended treatments will have on your skin. Then, I will show you photos of surgical results of cases similar to yours so you can understand the objective of the procedure.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use among those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery) as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

It may be necessary to perform a blood test, depending on the type of anaesthetic (local or general).

For general anaesthetics, you will need a consultation with the anaesthetist in the weeks leading up to the operation and at least 48 hours beforehand.

No medication containing aspirin or anti-inflammatories may be taken within 10 days of the procedure.

For general anaesthetics, you will have to fast strictly for 6 hours before the operation (do not eat anything, chew gum, eat sweets or smoke). For a local anaesthetic, however, you can drink and eat lightly at normal mealtimes.

Smoking can cause scarring problems.

Your stay in hospital is usually limited to half a day in a day hospital.

The duration of the operation is about 45 minutes. You may then go home after a few hours of monitoring following the operation.

Local, deep local (neuroleptanalgesia) or general according to your preferences.

Before you go to the operating theatre, in your room, I will go over the precise goals with you as we agreed during the consultations. You can then always make recommendations and ask any questions. I will then draw the lines and marks on your skin to guide the operation.

Treating a fatty excess by liposuction

The localised fat to be treated is infiltrated with a mixture of saline, local anaesthetic and a product to limit bleeding using a 1.5mm micro-cannula. Liposuction is then carried out with a 2mm suction cannula.

The areas usually treated with this micro-liposuction technique are the jowls and the double chin.

There are no scars because the micro-cannulas are introduced through needle puncture holes that leave no marks.

At the end of the operation, a compression dressing is applied to protect the skin on the treated areas.

Treating the "Bichat ball"

Localised fat on the cheeks is known as the "Bichat ball" and is located deep in the thickness of the cheek. This fat ball is removed through a 1cm incision inside the mouth in the upper gingival fold. This does not leave any scar on the skin. A dissolving gum stitch is placed in the gum and this does not require removal.

Treating empty or sagging areas by injecting your own fatty tissue (lipofilling)

Fatty tissue that is intended to be reinjected is removed during local micro-liposuction, if necessary (when treating the jowls or double chin), and/or on an area of localised body fat such as the hip, where the fat is of excellent quality to support re-implantation. In fact, with lipofilling, part of the transplanted fatty tissue will be reabsorbed and part will be maintained when it is revascularised like normal local fatty tissue. The percentage of this fatty tissue graft that is taken varies according to each individual and is between 30%-80% of the volume of fatty tissue injected. It is necessary, therefore, to take a larger volume of fatty tissue to be able to overcorrect the area, overfilling it by at least 30% (a total overcorrection of 130%).

The reinjection process uses a 1.5mm micro cannula in small strokes so the graft does not accumulate in a single place but is evenly distributed over the entire area that needs to be filled.

There are no scars because the micro-cannulas are introduced through needle puncture holes that leave no marks.

Any pain is very moderate and most of the time there is no need to take pain killers.

You may also have swelling (oedema) or bruising, which varies from case to case and takes a few days to almost completely disappear. You can, however, mask this with suitable make-up designed for post-operative use the day after the operation.

You will need to take about 5 days off work and social activities.

Clean the face daily with a mineral water spray.

If incisions are made inside the mouth, antiseptic mouthwashes should be used for a week after each meal and after brushing your teeth.

If any stitches are used, these are absorbable and do not need to be removed.

You will need to make a follow-up visit 3 days after the procedure, then after 15 days, 1 month, 3 months, 6 months, and 1 year.

• Exposure to the sun: no direct exposure before 1 month, then exposure is possible using a sun protection cream with a maximum protection factor.

• Bruises can be hidden using a suitable cover-up cream designed for post-operative use the day after the operation. The products used must be adapted and designed for post-operative use. They will be prescribed to you on a post-operative prescription.

Balancing fatty areas improves aesthetics and gives an impression of facial tone. The improvement is immediately visible despite any oedema (swelling) and possible bruises that prevent us from fully seeing the end result. After about ten days, your progress will allow us to appreciate the result, even if this takes 1 to 3 months to stabilise.

With lipofilling, the fatty tissue transfer contains a good proportion of what we know as “stem cells”. These can regenerate local tissues, improving your complexion, skin volume and appearance.

In the long term, the fat volumes will harmonise and stabilise so they are sustainable and the majority of patients do not need another operation. The ageing process means that some patients may need to repeat the lipofilling procedure a few years later.

However, to delay the ageing process, maintenance is possible using lighter treatments such as hyaluronic acid or botox injections or chemical or laser peels.

The result is a relaxed, rejuvenated face, giving you an undeniable feeling of well-being. Your friends, family and colleagues will notice a change and an improvement but will not be able to put this down to a particular treatment.

The cost of the operation will depend on the procedure to be performed, the duration of the operation, the type of anaesthetic and any hospital charges.

If the operation is purely aesthetic, you do not have the right to reimbursement through Social Security. On the other hand, if it is for reconstructive purposes after an accident or an illness, you may be covered by Social Security and, if necessary, by your mutual insurance company.

You will receive a detailed estimate during the first consultation, according to the options chosen. You then have a minimum legal period of 15 days to reflect on this and take your project forward.

The first consultation costs €50. The following consultations before and after the operation are free.