Q: Dr. Eppley, You gave advice to someone with jowls on Real Self where you advised to have jowl liposuction. But everywhere else I read that jowl liposution is dangerous because risk of nerve damage. Could you explain why are in favor of jowl liposuction in that area.
A: The safety and effectiveness of jowl liposuction depends on the quality of the overlying skin and how one chooses to access the jowls. With good quality overlying skin that is not associated with a facial jawline sag from aging, jowl liposuction can be effective. The only potential risk of injury to the jowls is the marginal mandibular nerve (which controls the movement of the lower lip) which does not actually run through the jowl area proper. The risk of injury to it is in the approach or access angle to it. If you come from below in the traditional submental approach to neck and jowl liposuction, as many plastic surgeons do, the risk of injury to that branch of the facial nerve is very real. But if you access the jowl area from a small incision inside the corner of the mouth and come from above, there is no risk of injury to that nerve branch. As I have done many perioral mound liposuction procedures, which is the area right above the jowls, it is straightforward to continue further down and treat the jowl area also if needed.
Dr. Barry Eppley