What to Expect Immediately Following Surgery
When you wake up after surgery, you will be wearing a chin strap that feels tight under your chin. It has Velcro straps that can be loosened if it feels too tight. This strap is removed in the office the day after surgery. It helps to reduce swelling after surgery. Occasionally, a drain is used and this is typically removed the day after surgery as well. If you are planning to be at home anyway, you can wear the strap to help the swelling go down faster, but this is not mandatory. You can shower and bathe the day after surgery, after your office visit.
- Numbness under the chin: Because the fine sensory nerve branches to the skin have been traumatized by the liposuction and some have been cut, temporary numbness is expected. It takes a few months for these nerve branches to regenerate. This does not pose a problem for patients; they just need to know to expect it. Men will have to be careful shaving because of this temporary numbness.
- Sutures: There will be either one continuous "running" suture that I take out three to five days after surgery, or "interrupted" sutures that I remove five to seven days after surgery. These are located just under the chin. Sometimes additional small incisions are used, placed in the earlobe creases. I use these for liposuction of the cheeks. This technique is used for patients with unusually "chubby" cheeks, often in combination with resection of the buccal (inner cheek) fat pads.
- Weakness of the lower lip on one side. Occasionally, patients experience weakness due to trauma to a motor nerve which supplies the muscle that pulls down on the corner of the mouth (the "marginal mandibular" branch of the facial nerve). This can cause a conspicuous asymmetry on smiling because the lower lip on the affected side will not move down to show the teeth on this side. This function returns as the nerve recovers.
Swelling the after the surgery causes firmness under the chin that can persist for a few months. Physicians call this "induration". This firmness often surprises patients. The swelling will go down and the hard feeling will go away and, within a few months, it feels just as soft as it did before surgery.
Fortunately, this firmness is not evident to others. Occasionally, if the firmness does not seem to be softening, I inject a small amount of a steroid solution to help it resolve more quickly.
Even with swelling, most patients are very pleased to see a reduction in the fullness under the chin as early as the day after surgery after the chin strap is removed.
Scarring: The scar starts out raised and feels thick. There may be some irregularity of the scar. With time, the scar gradually softens and flattens, like scars everywhere.
Bruising is the giveaway after this surgery and it is not where you might predict, not in the area under the chin, but farther down on the neck, even extending on to the chest. This is because bruising is caused by blood under the skin that is left over from surgery. It tracks down with gravity, even extending on to areas that were not treated at all during surgery. Fortunately, bruising of the lower neck can be hidden with clothing. Usually younger patients bruise less than older patients.