Chin Lipo uneven - what can be done to fix this? (Photo)

Question

I had lipo on my chin about 3 months ago and I have noticed some unevenness and hollow lines underneath my chin. Is this due to the surgeon taking too much fat? And what can be done to fix this

Raffy Karamanoukian, MD, FACS · Answer

a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jeffrey Lisiecki, MD · Answer

You should be seen in person to see and feel what is going on with these irregularities. At 3 months, you are probably too early to act upon this, as revision surgery should only happen when you are healed and all the swelling has resolved. Depending on the etiology of the irregularities and the contour of the surrounding areas, revision liposuction, morpheus8, and possibly fat grafting are all potential modalities.

Daniel Barrett, MD · Answer

Dear buckm2012,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

I would try a few sessions under local anesthesia fat grafting (nano & micro) w injection of Sculptra. Fees from $3,000/session. Best to do virtual.

Mats Hagstrom, MD (license on probation) · Answer

At three months your results are final and they are not going to change by waiting further.

It looks like your surgeon lacked the skill to do quality work and removed fat in an uneven fashion.

Liposuction is permanent in wireless irreversible. Treatment options for poorly done Liposuction come down to doing revision Liposuction when an attempt at evening out the fat by removing more fat. In someways it’s insult to injury but can help especially if someone has not been over treated.

Fat transfer is probably realistically your best option but also it’s very difficult and to keep typically requires more than one procedure.

Grafting fat successfully requires having an abundance of host tissue and the areas where you need the fat the most is also the most devoid of post tissue.  This means grafted fat will survive the least where you need it the most.

Still, a small amount of fat can probably survive and it can be built up by doing multiple procedures until the subcutaneous fat layer has been restored representing something closer to normal.

The third option some people trying is converting the procedure to A skin tightening procedure.  Doing so has no influence on the fat distribution and is probably not a realistic option in your case.

The first person to follow up with is the provider or surgeon who did your procedure.

That person should at least be aware of what the results look like so they can either stop doing the postsection or maybe take some training classes or at least be more cautious.

Delivering consistent high-quality Liposuction results is more difficult than most people believe.

Most people assume that it’s an easy procedure and anyone who is board-certified in plastic surgery with an overall good reputation should be able to do these procedures without creating a problem.

With that said, revision work is technically many times more difficult than Primary work and fat transfer is far more of a complex procedure than Liposuction.

In other words if your provider didn’t have the skill to do a fairly straightforward simple primary liposuction procedure then they may not have the skill necessary to do revision work without making  things worse.

Your provider may offer you revision work and it’s up to you if you feel comfortable with him or her doing that.

The following is a list of general recommendations for those seeking cosmetic surgery. Perhaps you’ll find this list useful though at this point perhaps a little late.

1. I recommend patients avoid traveling long distances for elective surgical procedures. There are of course instances where there is a lack of local talent and traveling to some degree is inevitable. If traveling for the procedure patients should be ready to travel to have the consultation, post operative appointments and follow up should there be issues or complications.
Patients sometimes do not appreciate the importance of in person consultations, that complications do happen or the number of people who have issues with their results or need revisions.

2. Schedule multiple consultations with different providers in your area who seem to have a good reputation for the procedure you’re interested in. Starting with at least five consultations seems like a reasonable number to me.

3. Whenever possible schedule in person consultations.  
4. During in person consultations ask each plastic surgeon to show all of their before and after pictures for the procedure you’re interested in.

The goal is not to see the best results of their career but to get an idea of what average results look like and get some type of confirmation of how many of these procedures that provider has performed.

Ask to see results that were not as good as the doctor would’ve hoped for and talk about the differences in outcomes.

Honest and experienced providers should have no problems presenting this type of information.

A highly experienced plastic surgeon should have hundreds of before and after pictures for the procedure you’re interested in. At a minimum at least 50+

5. Read all the reviews on various physician review websites paying close attention and avoiding providers with any significant number of justified negative reviews.  Providers with an abundance of reviews often have aggressive marketing campaigns.

The plastic surgeons I respect most all have the single variable of not having justified negative reviews on their online profiles. 
In my opinion justified negative reviews are far more telling than an abundance of positive reviews.

6. Avoid scheduling for surgery or making a deposit on the day of the consultation.  Give yourself some time to think about the decision and make sure you finished all scheduled consultations before committing to having surgery that will permanently and irreversibly change your body.

When in doubt slow down and schedule more consultations.

Choosing the right plastic surgeon is the single most important variable to having a positive experience.

7. Don’t go chasing after technology or names of certain equipment. Instead focus all your efforts on finding the most experienced and talented board-certified plastic surgeon.

Best,

Mats Hagstrom, MD

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