What Is The Risk Of Nerve Injury From Perioral Liposuction?

Q: Dr. Eppley, For a little background, I have had buccal fat removal in the past and found that it did not help with the chubbiness and volume in my lower cheek (area next to my lips). 

I’m now looking at perioral mound liposuction/reduction, and I could only find one surgeon in my area that does this procedure and maybe 3 surgeons country-wide. While looking at Real Self, I saw a couple doctors recommending against this procedure, so I was hoping I could get a second opinion from you regarding the safety/risks. I understand that there is a nerve branch running above the mouth and one along the jawline, so theoretically the perioral area should be free of major nerves. My concern is that if I have nerves that run lower or higher than normal (what is the standard deviation for nerve anatomy?), would I be at risk for severe nerve damage? Are there any other potential complications with this surgery? 

A: In answer to your perioral liposuction questions:

1) The effect of buccal lipectomies never reaches as low as the perioral region, no matte what surgeons say. You are a prime example of that basic anatomic concept of facial fat compartments.

2) There are no motor nerves that run through the perioral region. (south of a a line drawn between the corner of the mouth and the tragus of the ear) This is another basic anatomic principle that appears to have escaped those who portend there is potential nerve damage from liposuction in this area.

3) The question is never whether perioral liposuction is safe but whether it would be effective for your facial fullness.

4) Failure to use very small cannulas can result in irregularities/contour issues or over resection.

Dr. Barry Eppley

Indianapolis, Indiana