What needs to be done on my lower face after a botched submental lipo procedure 3 years ago? (Photo)

I'm sorry that you have had a difficult time obtaining the results that you wish to have to meet your level of satisfaction. Liposuction in the neck is a fairly simple procedure and most likely uncovered something else: enlarged and/or drooping submandibular glands. The solution for this problem is most likely a limited incision deep neck lift, but a consultation is necessary before making a definitive statement. Energy devices like morpheus will be absolutely zero help, so save your money on such "minimally invasive" devices.

Given the complexity of your situation following submental liposuction, a comprehensive approach may be needed to address both the lumpiness and skin laxity. Here are some potential options to consider:

Fat Grafting: This procedure involves transferring fat from another area of your body to the affected area to smooth out irregularities and restore volume. It can help improve contour and symmetry.

Dermal Fillers: Injectable fillers can be used to add volume and smooth out uneven areas. Hyaluronic acid-based fillers are commonly used for this purpose and can be adjusted over time as needed.

Microneedling with Radiofrequency: Treatments like Morpheus8, which you've tried, can continue to improve skin texture and tightness. Multiple sessions may be required for optimal results.

Surgical Revision: In some cases, a surgical approach might be needed to correct contour irregularities. A plastic surgeon can assess if a revision surgery could help address the lumpiness.

Skin Tightening Treatments: Continued use of non-invasive skin tightening procedures, such as Ultherapy or laser treatments, can enhance skin firmness and may improve the overall appearance.

Consultation with a Specialist: Given the complexity of your case and previous treatments, consulting with a board-certified plastic surgeon or a dermatologist who specializes in corrective procedures could provide a tailored treatment plan.

Each option has its own benefits and risks, and a detailed evaluation by a specialist will help determine the most appropriate course of action to achieve the best possible outcome.

Thank you for your inquiry and for sharing your photographs. It appears that the liposuction to the lower face and submental region has unveiled the presence of the submandibular gland, particularly on the left side. This is a common occurrence when the gland’s volume, previously camouflaged by superficial fatty tissue, becomes noticeable following liposuction.

The typical approach for addressing this involves a deep plane volume reduction in the submental region. This procedure targets the lower part of the submandibular glands, the digastric muscles, and the deeper-seated fatty tissue, aiming to align these structures with the jawline contour and reduce the girth of the upper third of the neck.

When there is residual looseness around the jawline, a skin-tightening procedure may be indicated to refine the contours. Additionally, in cases where the chin is under-projected (which I cannot assess definitively from your photographs), a chin implant could improve the jawline contour. This implant can be placed through the same submental access used for the neck lift procedure.

However, in your case, it is more likely that tightening the soft tissues of the lower face would provide a more balanced and harmonious improvement to the facial and neck features.