II. ADJUNCTIVE PROCEDURES

II.E. Double Chin

Fat accumulation that occurs beneath the chin (the "double chin") is often a major source of distress. Significant improvement in a patient's profile can be achieved by removing this fat (Fig. 6)." Liposuction of the double chin is performed under local anesthesia or under local anesthesia plus sedation. Patients who undergo this procedure in conjunction with rhino­plasty may have sedation or general anesthesia.

FIGURE 6. Liposuction (a) preoperative, (b) postoperative.

After the operation, a dressing and elastic bandage are typically applied to remain in place for a few days. The surgeon or his/her assistant will typically see the patient the day after surgery, at which time this ban­dage is removed and replaced with a smaller remov­able one. The patient is asked to wear this bandage for another full day, and then only at night for 3 days thereafter. The patient may gently shampoo the hair 24 hours after surgery.

Some swelling and bruising are normally present after liposuction. Generally, most patients appear quite sociably acceptable within a few days after surgery. The patient's head should be elevated on at least two pillows during sleep for the first 14 days, in order to keep the head higher than the heart to help facilitate the resolution of swelling. Patients may be up and around the day after surgery, but some naturalfatigue may persist for 2-3 days as a result of the nor­mal effects of the anesthesia and surgical procedure. In general, the patient should restrict normal activities, exercise regimens, and any activity requiring lifting or straining for approximately 14 days. It is acceptable to do some light walking 72 hours after surgery. Jogging and light noncontact exercises should not be resumed for 3 weeks, and strenuous sports require 6 weeks of healing before being safely resumed.

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