How to correct indent or “ditch” appearance 2.5 years after under chin lipo? (Photos)

Question

Hello, i had a face and neck lift with lipo 2.5 years ago unfortunately for me the surgeon took out all the fat and I have a ditch look under my chin. How can this be corrected? How many surgeries do you think it will take to fox this or make it look more normal. Thank you!

Anna Chacon, MD, FAAD · Answer

I can understand why this would be frustrating, especially after undergoing a face and neck lift with the goal of achieving a smoother, more youthful contour. When a depression or "ditch" develops beneath the chin after liposuction, it is often the result of over-reduction of fat, scar tissue formation, uneven healing, or a combination of these factors.

The encouraging news is that these types of contour irregularities can often be improved. The challenge is determining exactly what is causing the indentation.

If the issue is primarily volume loss, one of the most common solutions is restoring volume to the area. This may be accomplished with:

Fat grafting (transferring your own fat)
Soft tissue fillers
Other volume-restoration techniques

If the indentation is being tethered by scar tissue, releasing those fibrous attachments may be necessary before or in conjunction with adding volume. In some cases, the scar tissue itself is the main culprit rather than the absence of fat.

Because your surgery was performed 2.5 years ago, the tissues have likely reached a stable state. This is actually helpful from a treatment-planning perspective because what you're seeing now is likely close to the long-term result rather than ongoing healing.

As for how many procedures it may take, there is no way to accurately predict that from photographs alone. Some patients achieve a meaningful improvement with a single corrective procedure, while others benefit from a staged approach. Fat grafting, in particular, sometimes requires more than one session because a portion of the transferred fat may not survive long-term.

One thing I would emphasize is that perfection is rarely the goal in revision surgery. The objective is usually to restore a smoother, more natural transition beneath the chin and improve overall neck contour. Even when complete correction is not possible, significant improvement is often achievable.

Try not to lose hope simply because the result wasn't what you expected. Revision procedures for contour irregularities are not uncommon, and many patients are able to achieve a much more balanced appearance once the underlying cause of the indentation is identified and addressed.

Mehmet Ozdemir, MD · Answer

I completely understand how frustrating it is to deal with that indented, "ditch" look under your chin after your surgery, but please know that it can definitely be corrected. Based on your photos in image, the surgeon simply removed a bit too much fat, causing the skin to stick to the underlying muscle. To fix this, we need to put that missing volume back. The best and most permanent way to do this is through **autologous fat grafting**, where we harvest a little fat from your abdomen or thigh and carefully inject it into the depression to smooth everything out. Alternatively, you could use temporary **dermal fillers** as a quick, non-surgical fix, though you would have to repeat them every year. In terms of how many surgeries it will take, you should expect **1 to 2 procedures**. The first surgery will do the vast majority of the heavy lifting to fill the dent. However, because the body naturally reabsorbs about 30% to 50% of transferred fat, a minor second "touch-up" procedure is very common a few months later to perfect the contour. I highly recommend scheduling an in-person consultation with a board-certified plastic surgeon who specializes in revision work so they can feel the tissue and map out the best plan for you.

Mats Hagstrom, MD (license on probation) · Answer

Unfortunately, there’s no good treatment for what you need.
Too much fat was removed by overzealous Liposuction by your previous provider.
Most doctors are going to recommend fat grafting, but unfortunately fat grafting doesn’t work when there’s nothing to graft the fat into.
In order for fat grafts to survive there has to be tissue to graft into a.k.a. host tissue.
In your case, your skin on muscle and you can’t graft fat into the skin and you can’t graft fat into the muscle to achieve what you
need.
There are very complex reconstructive operations that could restore the tissue in this area, but simply grafting isn’t going to do it.
 I wish I could be more optimistic, but I prefer you not to waste money on procedures that won’t fix the problem or can’t potentially make things Anytime, fat grafting is done someone’s going to do Liposuction and as you know firsthand poorly done, Liposuction can lead to permanent problems.
Anyone who claims that this will work should show you previous examples, including long-term outcomes of similar cases.
I’ve been specializing in Liposuction and fat grafting for over 25 years.
I’m a board certified plastic surgeon and I’ve done more fat grafting than most will do during their career.
I’ve attempted to correct pour outcomes enough times to know what works and doesn’t work and unfortunately grafting fat when all the fat was removed previouslydoesn’t work.
For you and all the patients, I’ve tried to help. I wish it worked.
Your situation is unfortunate and I wish I could be more optimistic.
I think the best advice I can give you is to stay away from the trap of things getting worse or spending money on procedures that don’t work.
I wish it wasn’t so.
Mats Hagstrom MD

How to correct indent or “ditch” appearance 2.5 years after under chin lipo? (Photos)

Answers (3)

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