Laser-assisted Liposuction Combined with Masseter Dissection for Mid-lower Facial Recontouring

Abstract

ABSTRACT: Background: Asian women usually view the oval face, with a beautiful curve and clear outline, as elegant. The fat and bloated mid-lower face, with an undefined outline, takes away from what they perceive to be a beautiful appearance. Not only a bone but also soft tissue determine the shape of the mid-lower face. In this article, we introduce a modified surgical method of soft tissue for mid-lower facial recontouring, which can improve the fat and undefined outline of the mid-lower face caused by benign masseter muscle hypertrophy and reduce subcutaneous fat accumulation at the same time. The operative technique is simple and effective with few complications. Methods: The surgical treatment of 36 patients who met the adaptation criteria was carried out by laser-assisted liposuction combined with masseter muscle dissection. All patients were followed up postoperatively, and the surgical efficacy was evaluated on the basis of: the comparison of facial contours of patients before and after surgery, the change of masseter muscle thickness detected by B-ultrasound imaging, the satisfaction of patients with postoperative facial contour improvement, and the incidence of complications. Results: Between March 1, 2018, and August 31, 2019, 36 patients with indications underwent this procedure. The follow-up lasted 6 to 12 months postoperatively and demonstrated that all patients were satisfied with the postoperative results, of which 33 cases (91.7%) were very satisfied, and 3 cases (8.3%) were satisfied with the treatment and had obvious improvement of the appearance of their mid-lower face. Preoperatively, the average mandibular bigonial breadth was 138.6±8.3 mm, and the average thickness of the masseter muscle was 13.9±0.8 mm; the postoperative breadth was 123.3±7.7 mm, and the thickness was 10.1±0.2 mm. The average reduction of the lower face width and masseter thickness were 15.2±2.1 mm and 3.8±0.1 mm, respectively. No complications occurred among the 36 patients. Conclusion: The described method makes a great improvement in reshaping the outline of the mid-lower face, improves the fat and unclear outline of the mid-lower face caused by masseter muscle hypertrophy, and reduces subcutaneous fat accumulation. The procedure is easy to perform and is minimally traumatic, allowing for a quick recovery with few complications. These advantages along with the patients’ overall satisfaction with the results make it worthy of clinical application.