Is A Deep Plane Facelift The Only Way To Fix My Perioral Mounds?
Q: Dr. Eppley, I have had perioral mounds since I was a kid. I had micro liposuction and it made some difference but did not get rid of them as much as I would like. I tried device skin tightening but it didn’t make any further change. Several surgeons have suggested a deep plane facelift for any further improvement as they say there are anatomic constraints for doing liposuction. What do you think?
A:I have never been impressed with the results for any device skin tightening treatments 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 treated 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 tout 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 than the problem. In that regard it may be worth trying something far less in magnitude before committing to that type of effort and scar tradeoffs..
Dr. Barry Eppley
World-Renowned Plastic Surgeon

North Meridian Medical Building
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