Why is my double chin still present after chin lipo? (Photo)

Question

I had liposuction done 1 year ago on my chin and jawline area. The results were pretty okay; my jawline had less of a dip BUT now the droopiness has returned and the fat is back. Why? I spent a lot of money on the chin lipo and now I'm disappointed that my double chin is back. I'm not sure what to do

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

I am sorry about the disappointment you had from chin liposuction. However, you need to appreciate that your provider has been adequately careful to avoid giving you you contour irregularities in the hope that the result would be exceedingly what liposuction can do.

The problem you are experiencing is related to volume situated deep to the platysma muscles and not affected by liposuction. It is a combination of 3 different tissue types: Fatty tissue, the anterior belly of the digastric muscles, the lower part of the submandibular glands.

Because you do not have any problems with skin laxity, they can be addressed by removing volume through a deep plane anterior neck lift or short scar neck lift intervention. This does involve however a scar under the chin to produce the changes.

Randal Haworth, MD, FACS · Answer

It's important to note that liposuction is not a weight loss solution or a permanent fix for eliminating fat in a specific area. While it can effectively remove fat cells from the targeted area, the remaining fat cells can still expand if you gain weight, leading to a recurrence of the double chin.

Factors such as genetics, lifestyle, and age can also contribute to the return of fat in the chin and jawline area. Therefore, it is essential to maintain a healthy diet and exercise regularly to keep your weight in check.

Additionally, if you are experiencing droopiness or sagging in the chin and jawline area, you may want to consider other treatment options such as a neck lift, facelift, or injectables like Botox or fillers. These options can help improve the appearance of your chin and jawline by tightening and lifting the skin.

It's best to consult with a skilled board-certified plastic surgeon who can assess your individual needs and recommend the most appropriate treatment plan for you.

I hope this helps,
best of luck !

Matthew Schulman, MD · Answer

Liposuction removes fat. But a double chin isn't always from fat. It can be from loose skin, loose muscle, or just the shape of your bones such as a small chin or mandible. This could explain why you still see a doubel dhin after your chin liposuction. It is best to discuss your results with your surgeon.

Jason Emer, MD · Answer

"For a double chin, InMode FaceTite with VASERlipo would give you the best result.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Jeffrey H. Spiegel, MD · Answer

Sometimes the fat that is the problem is deep to the platysma muscle and needs surgery. Other times it is more superficial and liposuction works well.  But, you can also do skin and tissue tightening with radiofrequency fat melting that will tighten the neck.

Darryl J. Blinski, MD · Answer

Hard to answer without at least virtual consult with... Did you gain weight in the last year after the initial surgery? Was the results just barely ok? Where you under treated? You see many areas to discuss. Seems only revision lipo with possible HA fillers along jaw line or even a My Elevate neck lift suture is indicated.

Camille Cash, MD · Answer

Before and after photos would be helpful to give you a more insightful response.  Have you discussed your concerns with your surgeon?  If you have gained weight that could impact your results.  Perhaps not enough fat was removed?  I encourage you to visit with a board certified plastic surgeon for an evaluation.  You can consider further liposuction if indicated.  You could also explore Morpheus8 treatments for improvement.

William Portuese, MD · Answer

It's very important to understand that there are two compartments of fat in the neck, and they're located both above and below the platysma muscle in the neck. Liposuction can only accomplish a partial removal of the fat deposits above the muscle. You probably have fat deposits located below the platysma muscle which is going to require a necklift procedure as an outpatient procedure.

Mats Hagstrom, MD (license on probation) · Answer

Individuals who have a double chin typically do not have an abnormal fat distribution. The underlying problem is almost always based on the facial, skeletan imbalance with a Mandible, that is small, and lacking in projection in comparison to the maxilla.People seeking chin and neck Liposuction universally have the following features. Amendable, small, or lacking in projection, in comparison to the Maxilla. This intern often presents with a dental over by the occlusion. Profile pictures will typically show the upper lip as having more for projection than the lower lip. This causes the underlying platysmal muscle of the neck in a more oblique fashion.
This imbalance also causes a lack of John line, definition and premature jowls.
Well done, Liposuction can give impressive result, especially in individuals who are excellent candidates. Ideal candidate for this procedure are typically younger individuals who have a good skin elasticities with sufficient amounts of fat to remove it to have an impact.
Delivering consistent quality, Liposuction results is more difficult than most people believe. There’s a substantial difference in outcome, depending on who you choose as your provider. The number of plastic surgeons who can deliver consistent quality results, including making accurate assessments and deliver predictable outcomes is in a minority. Patients should be more selective they think necessary when it comes to choosing providers for any type of liposuction procedure. I typically recommend patients to do this by in person consultations before scheduling surgery. This may seem excessive, but finding the best provider is the quintessential, most important variable in getting quality outcomes. 
There are basically only two variables that determine quality cosmetic surgery results. Those are the patients individual candidacy for the procedure combined with the skill of the surgeon. There isn’t much patients can do to change, but patients do have control over choosing providers.
To find the best provider, I suggest patients schedule as many in person consultations as possible. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients with similar facial or body characteristics to your own. And experience plastic surgeon should have no difficulty showing after pictures of at least 50 previous patients. Being showed a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average result look like in the hands of each provider or how many of these procedures any one individual surgeon has actually done. 
To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. Showing what you look like now doesn’t tell us of the surgery. If you don’t have proper before and after pictures and ask your surgeon. Consider re-posting with proper before and after pictures or schedule in person and second opinion consultations with other plastic surgeons in your community. For a second opinion consultations patients should come prepared bringing with them copies of their before and after pictures and a copy of their operative report which are available from your current providers office question upon request. 
Getting a quality assessment of the lower 1/3 of the face should include an assessment of bone structure. Consider consulting with oral surgeons as well as plastic surgeons. Plastic surgeons tend to be more soft tissue focused while oral surgeons tend to see things more for my facial, skeletal perspective.
Both specialties contribute greatly to facial aesthetics for this part of the face.
Best,
Mats Hagstrom, MD

Why is my double chin still present after chin lipo? (Photo)

Answers (9)

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