Age 37, chin lipo 6 months ago & now have loose skin & unevenness, is there anything that can be done? (Photos)

Question

A follow up of my previous question: I am 37 years old, I am not over 50. The chin liposuction took place 6 months ago. Now I have this loose skin and unevenness. I am attaching also the photo before the surgery. My doctor says he is not responsible anymore since he can't guarantee how well will the skin sit and tighten. Is it lost or is there is anything that can be done to improve the situation?

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy  is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy  is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 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.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Mats Hagstrom, MD (license on probation) · Answer

I think I answered a previous question you posted regarding the same outcome.
The primary reason for your double chin was not an abnormal fat distribution but rather having a mandible that is small in relationship to your maxilla. Whenever we attempt a soft tissue solution to a problem that is inherently skeletal in nature a partial improvement is usually the best we can hope for. 
Growing a bigger mandible isn’t a realistic option so surgeons turn to what they can work with. 
There really isn’t a whole lot your surgeon can do after the fact.
Liposuction results are permanent and irreversible.
Had your surgeon had more skill and experience than perhaps they would’ve been a little less aggressive and delivered a little bit more even results. Patients often complain of a “lack of results” so there is constant pressure on plastic surgeons to deliver aggressive outcomes. People don’t want a little change. They want to look great. When we go for broke and try to maximize results then we also increase the risk of creating new problems. 
In a perfect world, they would’ve also warned you that some skin laxity may come from this procedure, especially if most of the fat is removed.
Delivering consistent quality liposuction results, including the ability to deliver predictable outcomes turns out to be more difficult than most people realize.
The number of plastic surgeons who approach mastery of this procedure is in reality quite small.
Most plastic surgeons think they’re better at Liposuction than they actually are.
Surgeons are responsible for their surgical outcomes and patients are responsible for provider selection. 
The loss of skin elasticity is a gradual phenomenon that does not have a quantum change at age 50.
Candidacy for Liposuction results decreases with age.
Young people have better skin elasticity, and as we age, the loss of skin elasticity increases the chance of skin compromise from having subcutaneous fat removed. What may work on one patient may not be such a good idea on another one. The ability to differentiate each unique patient’s candidacy for the procedure is part of mastering this operation. 
Correcting Liposuction outcomes is inherently difficult and sometimes not possible.
I recommend anybody considering permanent irreversible body contouring procedures to proceed with caution. 
I recognize you’ve already had the procedure, but for those considering having Liposuction, the following may be helpful.
I generally always recommend patients have multiple in person consultations before considering selecting a provider.
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 who had similar body/facial characteristics to your own.Bring pictures of yourself to use as reference for each consultations, especially when reviewing before and after pictures.
Highly experienced providers should ideally have access to hundreds or preferably thousands of before, and after pictures to choose from.
Being shown a handful of pre-selected images representing only the best results of a provider career may be insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results will look like or how many of these procedures they have actually done. Insist on seeing enough before, and after pictures to get confirmation of what typical results will look like. 
It’s also important to be shown previous patients who had similar characteristics to your own period
This means similar age, similar skin laxity, and similar amounts of subcutaneous fat.
Results from plastic surgery are generally based on both the surgeons skill and patient’s candidacy. In the end both the surgeon’s skill and patient’s candidacy are probably equally as important. 
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely are to find the better provider for your needs.
The biggest mistake I see patients make is having on the one consultation and then scheduling surgery.
When Scheduling only one consultations patients more or less eliminate the ability to choose a better provider.
 The second biggest mistake I see patients make is assuming that somebody who has board certification in plastic surgery with years of experience and a handful of positive reviews has mastered most plastic surgical procedures. This is often not the case. Exceptional surgeons are not common. 
I’m sorry if my response comes across as being blunt, forward and lacking enthusiasm for improving your outcome.
It is my goal to help people minimize the chance of being left disfigured from poorly done Liposuction.
I spent hundreds of hours trying to educate people by answering questions on this website to help people prevent exactly what happened to you.
Unfortunately, there are a lot of plastic surgeons who simply aren’t good at Liposuction.
The procedure is inherently more difficult than most people recognize.
The number of people requesting Liposuction, who are in fact, excellent candidates is also relatively small.
I would say in my practice, only 25% of individual seeking consultation are in fact good candidates for Liposuction.
The skin laxity and uneven contour that came from your procedure is unfortunate. As is often the case both expectations and execution of the procedure could have been done a little better. 
I think some would say the overall outcome is an improvement but is less than ideal. It may not have been possible to get an impressive “fat removal” without some skin compromise. I wish I could offer an easy way to improve your outcome. I don’t think there is one. I believe those who have been disfigured or had bad experiences with plastic surgery deserve to hear the truth.
I think plastic surgeons of good moral character will take ownership of their own results. That still may not give them the ability to correct less than ideal outcomes. 
As plastic surgeons we have all had complications and had outcomes that left both patients and ourselves disappointed. I find being honest about this is better than trying to hide what’s obvious. 
It’s unfortunately quite rare for a plastic surgeon to say “I’m sorry” or “that did not turn out as well as I had hoped” 
Best,
Mats Hagstrom MD

Age 37, chin lipo 6 months ago & now have loose skin & unevenness, is there anything that can be done? (Photos)

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Age 37, chin lipo 6 months ago & now have loose skin & unevenness, is there anything that can be done? (Photos)

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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.