Laryngeal Edema Due to Cervical Hematoma Following Submandibular Liposuction: A Case Report

Submandibular liposuction is a common and generally safe cosmetic procedure performed under local anesthesia. However, postoperative neck bleeding may sometimes occur and can lead to airway emergencies. We describe cautionary issues related to neck hematoma specific to post-cosmetic procedures. A 54-year-old woman developed progressive neck swelling and dyspnea immediately after submandibular liposuction at a cosmetic surgery clinic. Flexible laryngoscopy revealed laryngeal edema with airway narrowing, and emergent intubation was performed. Contrast-enhanced CT demonstrated bilateral submandibular hematomas with arterial-phase extravasation in the right submandibular region and venous-phase collapse of the left internal jugular vein. Hematoma evacuation with neck incision and tracheostomy were performed after obtaining consent the following day. The hematoma was located underneath the platysma, which may have resulted from injury to the facial vasculature caused by inadvertent trauma during liposuction. Postoperative recovery was fair. Specific issues related to submandibular liposuction include that the procedure is performed for cosmetic purposes, usually without skin incisions, and that laryngeal edema may occur secondary to compression of the internal jugular vein by the hematoma, disrupting venous outflow from the larynx. This case highlights the importance of early hematoma evacuation and decisive airway intervention in the management of serious postoperative neck bleeding.