Assessing the Efficacy of Submental Liposuction Association in Orthognathic Surgery: A Systematic Review.

[PURPOSE] Despite the vast literature on submental liposuction, there are few studies describing its simultaneous association in orthognathic surgery. This systematic review aimed to evaluate the available evidence on the effectiveness of the combination between the 2 techniques.

[METHODS] This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist and used a comprehensive literature search across 7 databases. All studies discussing submental liposuction in orthognathic surgery were eligible for inclusion, regardless of language. The Joanna Briggs Institute assessment tools were used to assess risk of bias. After a 2-step selection process, a total of 10 studies were included, including 2 cohort studies, 1 case-control study, 1 case series, and 6 case reports.

[RESULTS] Sixty-seven patients from 5 countries were evaluated. Ages ranged from 15.1 to 50 years. The prevalence according to the facial pattern was similar, with a higher incidence in women. The major indications for surgery were related to the presence of skeletal deformities and aesthetic changes in the cervical region. The forms of evaluation used to indicate surgery were photographs (n = 29; 43.28%), visual scale by 2 surgeons (n = 20; 29.85%), clinical examination (n = 23; 34.32%), and cephalometric analysis (n = 17; 25.37%). The postoperative follow-up time ranged from 6 months to 7.9 years. Despite the different forms of evaluation, all articles mentioned benefits with the association of submental liposuction in orthognathic surgery. The most cited complications were sensory changes in the lower lip (n = 4; 5.97), facial nerve injury (n = 2; 2.98%), infection (n = 2; 2.98%), maintenance of submental lipomatosis (n = 2; 2.98%), and skin irregularities (n = 2; 2.98%).

[CONCLUSION] This systematic review showed that submental liposuction associated with orthognathic surgery improves cervical aesthetics and that it is safe, with a low rate of complications. However, the number of studies on this topic is limited, and the studies are not standardized. There is lack of information especially regarding the evaluation methods used. Metric techniques such as ultrasound and tissue caliper adipometry could be possibilities for future studies.