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PEER-REVIEW | FACIAL CONTOURING | Key points


■ Cervicofacial liposculpture has made a considerable contribution to neck and facial plastic surgery. The procedure allows for a significant rejuvenation of the face


■ On a motionless face, the signs of youth are displayed in the absence of thickened contours on which skin drapes itself without folds or excess


■ Undertaking an initial questionnaire is paramount before any procedure to record the patient’s medication history


■ Non-aspirated cannulation obtains a cicatricial fibrous tissue and a cutaneous retraction that allows the redefinition of the oval of the face. This cannulation must be strictly carried out within the fatty tissue in order to induce a fat-on-fat scarring process


Figure 7 43-year-old male patient (A) before and (B) after liposculpture of the neck and jowl line


■ Second step: superficial cannulation, guaranteeing a good cutaneous retraction.


Results will show a 20% reduction of fat after 10 days;


50% after 3 weeks; 80% after 2 months; and 100% after 6 months. Like neurones, adipocytes do not multiply (they


Like neurones,


adipocytes do not multiply (they simply shrink or


grow); these are the only two kinds of cells that do not have cellular


multiplication ability.


simply shrink or grow); these are the only two kinds of cells that do not have cellular multiplication ability. If this is regrettable as far as neurones are concerned, it is quite beneficial with regard to adipocytes. During the slimming process, the volume of the cells decreases, which explains the effects of Ôyo-yoÕ dieing: women in particular will regularly lose weight and then put it back on. During a lipoplasty surgical intervention, the number of adipocytes decreases, and for this reason the intervention is definitive. Furthermore, the skin does not sag after the intervention, but retracts, easily covering the maxilla without excess. Fibrosis is inevitably a consequence of


superficial cannulation and consequently cutaneous reaction, even when there is almost no presence of fat in emaciated faces. According to Illouz6


,


the scarring fibrosis induced by cannulation is as important as the uplift or separation during a lifting.


Conclusions Liposculpture tunnelisation induces an ascending cicatricial fibrosis that redefines the oval of the face and the


under-chin area. Safety measures are respected by a quality tumescent


48 ❚


infiltration and the use of a 2 mm or smaller cannula or better still, an olivary cannula. Do not hesitate to multiply entry points in order to remain completely parallel to the cutaneous surface. Cervicofacial liposculpture allows, first with a non-aspirated cannulation, and further associated with


January/February 2013 | prime-journal.com


an appropriate adipocyte aspiration, and finally a superficial cannulation to restore the oval of the face. This lifting effect is obtained through a retractile cicatricial fibrosis. The procedure gives excellent results that vary according to the patientÕs condition and the doctorÕs skills.


 Declaration of interest None  Figure images 1-7 ç Jean-Pierre Amsellem


References


1. Trepsat F. SACS facelift. Video; 1993


2. Trepsat F. New face lifts: introduction. Ann Chir Plast Esthet 1994; 39(5): 525–6


3. Ellenbogen R, Motykie G, Youn A, Svehlak S, Yamini D. Facial reshaping using less invasive methods. Aesthet Surg J 2005; 25(2): 144–52


4. Klein JA. The tumescent technique for liposuction surgery. J Am Acad Cosmetic Surg 1987; 4: 263–7


5. Fournier P. Liposculpture: My Technique. 2nd edn. Arnette, 1996


6. Illouz YG, De Villers YT, Dankowski E. Body Sculpturing by Lipoplasty. Churchill Livingstone, 1989


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