Not happy with chin liposuction. Will further liposuction of my jawline make my lower face more contoured? (Photos)

Question

Hi there! 3 years ago I had liposuction done on several areas of my body. I am very happy with the result, except for my jawline. I had expected it to appear balanced (to me it seems more fat was taken from one side than the other) and contoured. Can further liposuction address the fat in my jowls, and accumulation along jawline towards bottom of my ears? I have always had an accumulation of fat in this area my whole life, the women in my family all have. I am 46 with moderate skin elasticity.

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

Jason Emer, MD · Answer

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear MrsFishertobe,
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

Either mini neck lift with SMAS plication & HA fillers to jawline or SurgiLyft techniques from Y Lift company. Expect fees in the $10,000+

Mats Hagstrom, MD (license on probation) · Answer

Your liposuction results look like they were done by someone who knows what they’re doing.

That said, in order for us to make an accurate assessment on the outcome of a procedure we always need to see proper before and after pictures. If you don’t have proper before and after pictures then ask your provider to forward the ones they took.  Plastic surgeons take pictures and very specific ways certain angles that standardize how we make assessments and interpret results.

You and the majority of the population have significant facial asymmetry.  Most people have the two sides of their face being quite different from each other. During embryological development the two sides of the face develop independently and eventually fuse in the midline.  This causes significant asymmetry. Scientific studies have shown that only about 2% of the population actually have some thing that resembles symmetrical faces.

Most plastic surgeons will not do liposuction above the jawline into the jowls because that puts the patient at risk for developing nerve injury of a branch of the facial nerve called the marginal mandibular branch.

It innervates muscles around the mouth and if injured creates a stroke like appearance when people show facial expression.

The nerve’s deep under the mandible and as a crosses the jawline it becomes superficial and can easily be damaged by doing Liposuction in the Jowls.

Nerve injury when it happens is usually temporary but can last several months.

Most plastic surgeons will not do liposuction for jowls.  Some will.

I suggest you follow up with your provider and discuss your concerns with him or her.

Maybe they are comfortable doing a revision procedure.

Personally I stay below the jaw line when doing liposuction but each provider makes their own decisions.

Best,

Mats Hagstrom MD

Not happy with chin liposuction. Will further liposuction of my jawline make my lower face more contoured? (Photos)

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