Can I Get Targeted Perioral Debulking?

Q: Dr. Eppley, I attached before and after photos for a procedure called FaceTite with microliposuction of the perioral mounds. I’m wearing very little makeup in these photos, and overall I’ve been bothered by my perioral mounds since I was a young adult. I’ve had them since I was even a child/teenager. 

I’ve consulted three different plastic surgeons, the last of whom was able to offer me that procedure. I do notice that it made a difference, but I was told that any further improvements could only be done via a deep plane facelift. I haven’t met a surgeon yet who has been able to offer targeted perioral mound debulking because of anatomic constraints. If Dr. Eppley could take a look and consult with me I’d appreciate it. I’m turning 33 in October, and since the surgeon that did my FaceTite procedure is open to a deep plane facelift, I’m strongly considering getting one within the next couple years.

A:I have never been impressed with the results for any Face Tite  procedure and I don’t really know what exactly is done with ‘microliposuction’ of the perioral mounds. In other words what size cannula was used, how aggressive and how much surface area was done in the procedure etc. I simply don’t know how thorough the liposuction was done. Microliposuction could mean an aggressive and extensive area was done using a miniature cannula to do so. It could also mean a very limited amount of area which traded hence the term micro.

When it comes to perioral mounds there really are no anatomic constraints. Anatomic constraints in the face typically means where are the branches of the facial nerve. But in the perioral mounds in the lateral facial area on a line between the mouth corner to the ear and down to the jawline there are no facial nerve branches in this area. While this is basic facial anatomy it seems to escape many plastic surgeons as they frequently tour anatomic constraints as to why it cannot be treated or or not treated much beyond the area right at the corners of the mouth.

That being said the real question is whether you would benefit by a more thorough treatment of your area of facial concern. It is hard for me to say, not knowing exactly what was done previously, as to whether further liposuction efforts have merit. I can only make the comment in reverse in relation to considering a deep plane facelift at your age. That is a bit like using a shotgun to remove an annoying fly in your house. The solution seems to be far greater been the problem. In that regard it may be worth trying something far less in magnitude before committing to that type of effort.

Dr. Barry Eppley

World-Renowned Plastic Surgeon