Patients have been made aware by advertisements of the technique called superficial liposuction since the mid to late 1990's. The face and neck have a blood supply that is totally different from that of the rest of the body. Surgeons specializing in facelifts realize, that in many instances, it’s possible to snip and cut very close to the undersurface of the skin of the face and yet not end up with patches of blood vessels or pigment after the face-lift is done. However imperfect, this is the way the majority of standard face-lifting procedures are done. Damage too high or close to the skin in non-facial tissues can cause scarring or other unwanted visible changes in the overlying tissues or skin.
Many surgeons became unhappy with their liposuction results in patients who were a bit older (many over 50 years of age). This was because the patient's skin became even sager or remained saggy following the removal of deeper fat. If a surgeon were to remove all the fat pushing out against the skin in older patients, the skin would usually not contract well after liposuction. Wrinkles and bruises more commonly form in older patients following typical liposuction procedures. Doctors have long known that by damaging the dermis, or leather layer of the skin, that the skin layer would tighten and contract in response.
The superficial liposuction was heavily marketed, as opposed to liposuction that involved removal of fat from the traditional location, which is in the lower to mid-fatty layers. Superficial liposuction near the surface of the skin may damage small blood vessels and nerves leading to the dermis (leather layer adjacent to the surface epidermis of the skin). The initial results of the contraction on some patients may have looked good, and the skin may have appeared "tighter." However, in many cases, the superficial liposuctions caused the overlying skin to die, leaving holes and ulcers that eventually scar. Quite commonly, patients receiving superficial liposuction had developed net-like congregations of blood vessels under the surface of the skin, with associated pigment discolorations. Like it or not, they most probably will stay with you forever…
Many times the unwanted changes do not arise right away. Some of the problems associated with superficial liposuction are the result of stripping the nerves that control the blood vessels that feed the surface skin. This is followed by new blood vessel formation in irregular, net-like patterns, as well as by the loss of the nerve control that governs whether the remaining blood vessels will be properly closed or opened (dilated).
Some of the cases of surface skin death (necrosis) and scarring may have been caused by surgeons who suctioned and rasped too close to the dermis (leather layer) of the skin. It appears that the tiny blood vessels feeding the dermis may be cut or damaged by the tearing effect caused by turning the suction hole of the cannula upside-down and applying a vacuum on the delicate underside of the dermis. Bad results are mounting, but some doctors, are still performing the procedure.
Eventually, the use of a flawed procedure should naturally decline (to zero), unless there is an improvement in the procedure. Many of today’s lifesaving procedures are improvisations of what started out to be risky procedures; take triple coronary bypass surgery, for example, which is now one of the greatest lifesavers. The problem is how to decrease the bad effects of "cosmetic experimentation" on the public.