Intraoral transmental suction lipectomy (TMSL) is performed by entering the suction canula through the chin osteotomy/ostectomy gap into the sub- and/or supraplatysmal fat tissue layers. The aim of the study was to know patients' and operators' satisfaction with the procedure, and to know the kind and frequency of the complications. Twenty patients were consecutively treated and reviewed after a minimum of 5 years. All were satisfied with the overall results. It proved difficult to differentiate between the results of the liposuction and those of the genioplasty and/or orthognathic profile correction. From a surgeon's point of view, 11 showed excellent, nine good and one moderate results. Complications included one local subcutaneous infection, four transient neurosensory disturbances at the lower lip and two marginal branch weaknesses. All complications were resolved by the time of the long-term follow-up appointment. TMSL offers the psychological advantage of being performed without skin incision. Cosmetic results and complications are similar to those obtained with the transcutaneous liposuction techniques.