Lipo or neck lift - can someone tell me if I will get a good result from lipo with chin transfers? (Photos)

Thank you for sharing your photos and your concerns. It’s very common to wonder whether liposuction alone will be enough or if a neck lift is needed to avoid loose skin.

Neck liposuction with fat transfer to the chin can help improve contour by removing excess fat and enhancing projection, which often gives the appearance of a more defined jawline. However, the main factor that determines your results is skin elasticity. If your skin still has good tone and “snaps back” well, lipo with chin augmentation can give you a smoother, sharper result without much risk of looseness.

If the skin has already started to show laxity or sagging, liposuction alone may not fully address it and can sometimes make looseness more noticeable. In those cases, a neck lift or a combined approach provides the best long-term improvement, since it removes excess skin and tightens underlying structures.

When skin tone is good, neck lipo with chin enhancement can give very nice results. If elasticity is more limited, adding a lift may help achieve the outcome you’re hoping for. With the right approach tailored to your skin, you can absolutely get a more defined and natural-looking profile.

Liposuction alone, based on your age and skin quality should give you a good improvement. I'm not a fan of fat transfer to the chin and would recommend a chin implant instead (for various reasons).
For a better result than lipo alone you could do necktite which will also tighten the skin.
All of these are office procedures in my practice.

From the limited photographs presented, you appear to have significant fat deposits, located both above and below the plasma muscle in your neck. Liposuction can only remove the fat deposits above the muscle, while a surgical neck lift is required to remove the fat deposits below the muscle in addition to a platysma- plasty, which significantly improves your jawline. You also have a recessive mandible bone, so consider augmentation of that bone with a chin implant, which gives better structural support for the soft tissues in the neck. Fat Transfers to that area don't work very well.

Based on your post of photos, the risk of Lipo of the under chin and neck area leaving irregular skin or hanging skin is over 50% in my opinion. But best to get more consultations, whether in person or virtual only board certified plastic surgeons. I think you need a full neck Lyft with under chin Lipo combination and fat transfer to anterior fee $12,000-$18,000. Again, virtual consult with.

This response is lengthy.
I use Word recognition so my apologies in advance for grammatical errors and the rambling nature of my communication.
Plastic surgery outcomes are generally based on two variables.
The first is the patient’s candidacy for the procedure and the second is the skill of the provider.
Both of these variables are probably equally as important for most plastic surgical outcomes.
A patient who is an excellent candidate for a surgical procedure has the potential of having an excellent outcome if they choose the right provider.
That same patient can end up with a poor outcome if the procedure isn’t done well.
a patient who is not a good candidate for a plastic surgery procedure doesn’t have the potential of having a good outcome, regardless of who they hire.
To understand what your results are likely to look like you need to first understand your candidacy for the procedure.
This is not at all easy or straightforward, and to understand your candidacy you need guidance from your surgeon.
The ability of the surgeon to give you quality assessment and describe your individual candidacy for the procedure is also a useful tool in vetting the provider.
those who have mastered Liposuction will have a better ability to assess candidacy and can generally deliver more consistent quality outcomes.
Facial aesthetics, especially in young people is primarily determined by bone structure.
Soft tissue coverage of the face and neck tends to be much more consistent from person to person.
What gives each unique person, their unique facial appearance, whether attractive or not so much is therefore based on bone structure.
Issues related to the lower 1/3 of the face are therefore generally related to the shape and slice of the mandible.
Those who develop a premature double chin, loss of jawline definition, and early nasolabial folds tend to be those who have a mandible that small or lacking and projection in comparison to their maxilla.
The problem with the lower 1/3 of your face and neck is not an abnormal fat distribution.
The problem is the shape and size of your jawbone.
Growing a bigger mandible isn’t really an option so surgeons turn to what they can work with which is soft tissue manipulation.
Well done, liposuction of the chin and neck can give a fairly dramatic results when done correctly on patient who are good candidates.
The best candidates for Liposuction are universally young people with tight skin who have thick layers of fat and no other issue keeping them from looking great.
The opposite is also true.
Older individuals, individuals with thin layers of subcutaneous fat, those with significant skin laxity or weak bone structure have less potential for getting high-quality results from Liposuction.
In regards to your candidacy for chin and neck Liposuction, I would say you are average. That means you have the potential for a nice improvement, but may not get the very best possible outcome, regardless of who you choose as your provider.
There is no such procedure as a chin transfer.
I think what you were referring to is fat transfer a.k.a. fat grafting.
Your surgeon is probably recognizing that weakness to your bone structure is the underlying cause and is hoping to augment the shape and size of your mandible by doing fat transfer a.k.a. fat grafting.
The concept is not wrong.
That said facial fat transfer is bites very nature, somewhat unpredictable.
It becomes difficult to assess quality outcomes when reviewing before, and after pictures when patients have had two procedures immediately adjacent to each other.
I’m assuming your provider showed you some before and after pictures.
Hopefully they showed you lots of them.
Hopefully, they showed you lots of quality before and after pictures of previous patients who had the same characteristics that you do.
That means they should be generally the same age, have the same bone relationship, the same thickness of subcutaneous fat, and the same degree of skin laxity.
Being shown only a handful of pre-selected images representing only the best results of a providers career of patients who were substantially better candidates for surgery may be insufficient to get a clear understanding of what average results look like in the hands of each provider or what your results will look like.
Hopefully, sufficiently experienced, talented and ethical provider will show you honest examples of previous patients who had similar characteristics.
Remember that plastic surgery outcomes are 50-50 based on the patient’s candidacy and the skill of the provider.
Finding the right plastic surgeon is not easy or straightforward
Likewise delivering consistent quality, liposuction, and fat transfer results is not easy or straightforward either. The number of plastic surgeons who approach mastery of this procedure is in reality quite small.
Most plastic surgeons are average and average result may not be that impressive.
Most patients are usually drawn to the very best before and after pictures and are hoping to get that kind of outcome.
Only the very best plastic surgeons become exceptional.
That is kind of the definition of the word exceptional.
To find an exceptional plastic surgeon requires a bit of work.
In my opinion, there’s no substitute except having multiple in person consultations with the ability to vet, plastic surgeons, and judge outcomes.
This means the patient needs to not only schedule a bunch of consultations, but also have the ability to judge who can deliver the best results on patients who have the same candidacy for the procedure.
Because patient candidacy has a major impact on what the results will look like it may not be easier straightforward to understand why some results look better than others. Some plastic surgeons don’t even know who’s going to get better results than others before surgery.
Understanding patient candidacy is on its own a fairly complex topic.
Mastering Liposuction includes both the technical ability to do the procedure well and also the ability to determine who’s going to get what outcome and deliver consistent results.
There should in reality be no guessing game and who is going to get the best outcome.
As sufficiently experienced plastic surgeon will know as soon as they meet the patient what their results are going to look like.
If they don’t, then they don’t have enough skill and experience.
The number of plastic surgeons who approach mastery of liposuction and fat transfer is in reality small.
I would say less than 5% of plastic surgeons approach mastery of Chin neck Liposuction.
That means in order to find the one plastic surgeon who is truly exceptional at this kind of work the average patient would need to do 20 consultations and then have to have the ability to pick the best one.
Having 20 in person consultations is excessive.
That said, having only one consultation, more or less eliminates the patients ability to choose a better provider.
Considering how few plastic surgeons are truly exceptional at this kind of work patients should use all of their ability on the one variable they have control over.
You can’t really do anything about your own candidacy.
What you do have control over is provider selection.
The more consultations you schedule the more likely you are to find a better provider.
I highly recommend patients avoid virtual consultations whenever possible.
I don’t think patients can properly vet plastic surgeons through virtual consultations.
My general formula for finding the right provider is the following.
Start by screening all the major plastic surgeons in your community who seem to have at least five or 10 years of experience and seem to have a lot of Liposuction before and after pictures that look good on their website.
Some plastic surgeons don’t like doing liposuction and some of them simply aren’t good at it.
Plastic surgeons who’ve done a lot of quality Liposuction should have a good representation of their previous work posted on their website.
If they don’t have any before, and after pictures of the procedure, you’re interested in then you probably shouldn’t be consulting with that provider.
Once you’ve narrowed it down to a handful of providers who have a fairly good track record of before and after pictures on their website of the procedure you’re interested and hopefully some quality reviews from patients who had the same procedure you can go ahead and begin scheduling in person consultations.
Considering that the outcome is permanent and irreversible I think having four or five consultations before considering selecting a provider seems appropriate.
Most patients don’t do anything to that.
The majority of patients have one consultation and then schedule surgery.
I can also tell you that the majority of patients posting on this website are posting because they’re unhappy with the results of their plastic surgery procedure.
When patients are unhappy with the outcome of their procedure, we can almost always deduct the problem as being the patient was not a good candidate, the surgeon didn’t have the skill and experience or a combination of both.
When patients schedule in person consultations, they should come prepared having with them a complete set of pictures taken the same way plastic surgeons take before and after pictures.
You need to have pictures of yourself to use as reference when you reviewing before and after pictures.
Don’t go by memory of what you look like.
In order to make sure you’re being shown pictures of previous patients who had similar Candidacy for surgery with the same tissue variables you need to be able to look at your own picture at the same time.
Ask the provider specifically to show you before and after pictures of previous patients who had the most similar characteristics to your own period
Again this should be similar age, similar skin, laxity, similar bone structure, similar thickness of subcutaneous, fat, etc., etc., etc. Take notes about the quantity and quality of before and after pictures taken.
Give results as score from one to 10.
Count exactly how many previous patients results they showed you.
Write these things down.
If the provider doesn’t have an endless supply of before, and after pictures, then ask them if they have more pictures, you can see.
If they start making excuses for why they don’t have more before and after pictures, then write down in your notes that the provider had limited numbers of before and after pictures and why.
The most common reason stop showing you before and after pictures is, they don’t have enough quality results to be proud of.
What you want is a provider who could spend the next three hours reviewing before and after pictures and not run out of examples.
Don’t schedule surgery on the same day as the consultation.
Make sure you finish all scheduled consultations before selecting a provider or committing to having surgery.
If you look back and still have questions or the provider didn’t go over certain information with you then contact that provider and ask if you can have a follow up appointment.
Make a list of all the major topics that should be covered during a consultation.
Check that list at the end of each consultation to see if all the topics were covered by the provider.
If providers covered more topics that you hadn’t thought of during the consultation, then add those topics to your list.
Things that should be discussed during consultation include. What procedure, conveying a clear understanding of what your concerns are, Discussing the main treatment and alternatives, a complete review of your medical and surgical history, and examination, and discussion of what to expect before and after surgery, risks of the procedures and what happens when complications actually do happen, what kind of results you can expect and a review of pertinent before and after pictures, what happens if you’re not happy with the outcome, the providers revision rates and revision policy, the type of anesthesia to be used, medication’s to be taken before or after surgery, the number of follow up appointments, etc., etc. In my opinion, a thorough consultation takes about an hour.
Are you still with me?
The whole process is highly complicated and not easy to understand.
Most of us spent at least 10 years in medical training just to start our practice.
To get good at plastic surgery requires an additional 10 to 20 years of practicing after we finish 10 years of medical training. The number of plastic surgeons who excel in the field and really demonstrate excellence and exceptional work is a small minority.
It is your job to find those few individual providers who stand out in regards to the quality of their work.
These are often not the same providers who stand out when you do a Google search.
Providers who put a strong emphasis on self promotion are usually not the providers you want to do your surgery.
What you’re looking for our providers who have a strong emphasis on patient advocacy not on self promotion.
The best plastic surgeon I know focus virtually no effort on promoting themselves or their practice.
They don’t engage in social media and they don’t Advertise or pay to be on this website or this platform.
I personally do not pay to be involved with this website.
I answered questions for free because I enjoy doing it.
This website hides my profile because I don’t pay for advertising fees.
Reviews are pretty important.
I would be leery of plastic surgeons who have excessive number of reviews.
The number of patients who on their own will go out and write reviews for plastic surgeons is in reality quite small.
All practices that have lots of reviews are encouraging their patients to write reviews for them. In some cases, they hire marketing companies and engage in behavior that is potentially unethical.
Most plastic surgeons don’t, but there are definitely ones who are out there to make money at any cost.
I suppose that is just how things work today.
What people say in the reviews and what procedure they had to justify that review are probably what you’re looking for.
Any provider who has a significant number of justified negative reviews should probably be avoided.
I don’t know how to put a number on this, but if 10% of reviews are justified negative reviews then I think that is a big red flag.
When I say justified it negative reviews it means that the patient describes a situation where they were harmed or abandoned.
The receptionist having an attitude is not a justified negative review.
If almost all the positive reviews are for Botox treatments and you’re having Liposuction then you’re really not seeing a lot of reviews for the procedure you’re interested in.
Ignore all the reviews written for treatments other than what you’re interested in.
Last but not least don’t forget the people who have a small Internet presence.
Some of the very, very best plastic surgeons I’ve ever known have virtually no Internet presence.
One surgeon didn’t even have a website.
He had patients fly from around the world to get facelift and he charged more than any other surgeon in San Francisco. He retired two years ago.
The single very best plastic surgeon I know doesn’t post any before and after pictures on his website.
His name is Mark Kobayashi MD and he works in Orange County.
If you Google his name, he does not stand out.
Many people looking go right by his name never knowing they just missed the single most brilliant provider.
There are virtually no pictures of his work and he really doesn’t have all that many reviews.
I’m 62 years old and I’ve seen a lot of surgeons operate.
Mark Kobayashi is hands-down, the single most talented plastic surgeon I’ve ever known.
Outside of his immediate community he’s not famous.
He’s never been on television, he doesn’t write textbooks, he’s not in the news.
He spends time taking care of patients and spends time with his family.
When it comes to plastic surgery, famous usually does not equal talented.
If anything, the most famous plastic surgeons are typically technically not very good.
If it was me having a procedure, I would insist on having five in person consultations before selecting a provider.
I would bring somebody with me to each consultation that I trusted.
I would take care full notes and I would push providers to show me more pictures.
I would probably realize that the first couple of consultations I knew so little that I had to do them again in order to judge that provider.
I think six months as a reasonable timeframe for vetting of providers and having the consultation process.
Most people are in a hurry and can’t justify the time to even scheduling one single in person consultation.
Most patients I see would prefer to do a few clicks on their cell phone, then come in for surgery.
Personally, I think virtual consultations for cosmetic surgery is one of the dumbest things you could possibly do.
To have a permanent irreversible aesthetic surgery without even meeting the person who’s going to do your operation seems insane to me.
Not all plastic surgeons are talented and doing some of these procedures well is way more difficult than people think. The difference between simply doing the procedure and doing the procedure well is the difference between looking like you had cosmetic surgery and a spectacular outcome.
The spectacular outcomes most people are seeking are the exception not the rule.
Good luck to your ventures.
When in doubt, slow down and schedule more consultations.
Mats Hagström MD