6 months after chin liposuction, neck is lumpy and uneven. Was too much fat removed and should I be concerned? (photos)

Question

I had chin liposuction 6 months ago, and I am very self conscious about how my neck looks following the procedure. I am wondering if this is normal - to me the neck area looks lumpy and uneven, with divots of fat missing and crepey skin between the playsmal bands. My doctor is offering to explore fat grafts but keeps insisting it looks normal to her. Would love a second opinion on whether I’m being crazy here to think it looks strange. Any suggestions for best fixes?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear Jess312,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, liposuction results is more difficult than most people believe. For this reason, I suggest patient be highly selective when it comes to choosing a provider. To do this, I suggest patients have at least five in person consultations before considering scheduling surgery. During each consultation, ask you to provide to open up their entire portfolio and show you their entire collection of before and after pictures of chin and neck liposuction of patients with similar facial characteristics. An experienced provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures. Being shown a handful of preselected images representing the best results over the entire providers career is totally insufficient to get a clear understanding of what average results look like or how much experience anyone provider actually has.
Liposuction results are permanent and irreversible. If done poorly, it can leave patients disfigured.
Revision work is many times more difficult than Primary Liposuction. If a provider does not have the skill to do primary liposuction well on a consistent basis, then they are unlikely to have the skill and experience to do revision work.If you opt to have revisions by someone who couldn’t do the primary procedure, there is a chance of them making things worse in an attempt at revision.
Fat transfer is difficult enough. Correct poorly done Liposuction with this technique is extremely challenging and unpredictable. The problem lies in the fact that the area where you need volume is now completely devoid of host tissue, which the fat graft needs to stay alive.Building up, fat with fat transfer to correct overly aggressive. Liposuction is a difficult procedure, and often requires multiple sessions. Because this type of work is far more complex and difficult than primary liposuction or primary fat transfer procedures it should be done by those who have sufficient skill and experience in both.
To make an accurate assessment on the outcome of a procedure we always need to see proper before and after pictures. If you don’t have a proper before and after pictures, then please contact your provider and ask them to forward the ones they took. When asking for a second opinion always bring with you proper before and after pictures and preferably a copy of the operative report. These are all available from your surgeons office if you request them.
The number of plastic surgeons who can consistently deliver quality liposuction results, and can accurately predict outcomes is relatively small. This procedure is more difficult than most people believe.
Because the results are permanent, and the potential outcome can be disfiguring. Patients should be extremely cautious when choosing providers.
For revision work all of these necessities are increased.
To make an assessment of your current situation it would be helpful to know your age because that has a lot to do with your candidacy for the original procedure.
As people age their candidacy for liposuction, especially of the neck is reduced. Individuals in their 20s and early 30s typically do fine but its patients enter their 40s and 50s the loss of skin elasticity makes keeping some of the subcutaneous fat important in order to maintain quality skin integrity. Removing fat aggressively can cause increased contour, irregularities and expose the underlying platysma muscle, including platysmal bands.
 At this point, I suggest you slow down the process significantly and think long and hard about the next step. I would be apprehensive about letting your provider go back in and try to correct something that they weren’t qualified to do in the first place. 
Be very careful with anybody suggests revision Liposuction(removing more fat) as a viable way of treating your outcome. Likewise, I’d be extremely careful with anybody who says using power equipment, such as VASER “can break up the scar tissue” to fix the problem.
Fat grafting may be a good option, but recognize that doing this is technically far more difficult than doing fat Transfer in other areas. The areas where you need volume now have it virtually no host tissue to support fat grafts. This means grafting should be done conservatively with an understanding that building up the volume of fat may require several procedures.
To find providers who have sufficient experience with facial fat transfer, I suggest going through the same process of having multiple in person, consultations and ask them to demonstrate as many before and after pictures as possible. For a revision work it is unlikely to get providers who can show you nearly as many before and after pictures as they can for primary procedures since revision work is not nearly as common. Some providers may also be reluctant to take on doing revision work for other providers undesirable outcomes. Once somebody else operates on you, they somehow become responsible for everything that’s happened in the past. Considering that Liposuction results are more or less permanent recognize that being expected to improve on the outcome, which is very difficult, is not necessarily a desire. Patient who have been disfigured from previous liposuction are also typically labor intensive and require lengthy conversations, including follow ups.
In the end, you will be the one making the decisions. By far the most important, single variable is finding the right provider.This is generally best done by having multiple in person consultations, and during those consultations patients should take an active approach, in vetting the provider in regards to skill and experience. Providers who think this is relatively simple to fix, should probably be avoided. 
To make a good assessment, we need standard before and after pictures.
Best
Mats Hagstrom, MD

6 months after chin liposuction, neck is lumpy and uneven. Was too much fat removed and should I be concerned? (photos)

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6 months after chin liposuction, neck is lumpy and uneven. Was too much fat removed and should I be concerned? (photos)

Answers (3)

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Everything you need to know about Chin Liposuction

Our mission is to create a world where every investment in modern beauty is Worth It.