To make an assessment regarding the outcome of any plastic surgery procedure, we need to see complete proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took. Without knowing what you look like before we can’t compare. Facial aesthetics are generally determined by bone structure. It is the facial skeletal structure that determines each unique persons facial appearance, and this includes the lower 1/3 of the face. Issues related to the lower 1/3 of the face are based on the shape and size of the mandible. Even if your doctor removed a substantial amount of fat, it is your mandible that determines what this part of your face looks like. Your double chin was not related to an abnormal fat distribution. That said well done Liposuction can give substantial improvements if done correctly on individuals who are good candidates. Candidacy for Liposuction can be summarized as someone who is “Young tight pudgy”. Most plastic surgery outcomes are based on two variables. The first is patient candidacy and the second is provider selection. Delivering consistent quality Liposuction results is more difficult than most people realize. The number of plastic surgeons who approach mastery of Liposuction is really small. Most plastic surgeons think they’re better at Liposuction than they actually are. Liposuction results also take time. Liposuction results should not be assessed until patients are at least three months out from surgery. What does your provider say about your outcome? During your consultation, how many before and after pictures did your provider show you? Did those patients have the same candidacy for the procedure as your own? Similar age and similar amounts of subcutaneous fat?How many consultations did you have before selecting your provider? In regards to age, I usually stop doing liposuction on people who are above the age 50. It’s not an absolute but as people approach the age of 50 they usually lose skin elasticity, and this is going to lessen the potential impact of Liposuction. Aggressive fat removal on people who have lost skin elasticity could also compromise what the skin looks like. As patients age, they generally lose their candidacy for liposuction and generally become better candidates for a neck lift. My first-hand experience with Renuvion is that it doesn’t add anything to the outcome of liposuction on its own, I purchased the device initially, but sold it because in my opinion and all of my patients opinions it didn’t deliver anything. In my opinion Renuvion completely fails to deliver what it claims. Based on what you describe, I think the lack of results are primarily due to the fact that your surgeon lacks sufficient skill and experience in combination with you being a less than ideal candidate.The number of plastic surgeons who can deliver consistent stunning Liposuction results is really small. I would say less than 5% of plastic surgeons have mastered this procedure. in reality, it may be even smaller. this means the chance of an average patient finding a plastic surgeon who is mastered Liposuction is less than one in 20. Unless you find a plastic surgeon who exclusively does liposuction for a living or works for a specialty clinic where they perform only Liposuction every day the chance of finding the right provider is small Finding plastic surgeons who are really good at liposuction is inherently difficult. Patients generally are unable to differentiate who is good and who is not at this procedure. The biggest mistake I see patients make is first having only one consultation and then scheduling surgery. The second biggest mistake I see patients make is assuming that a plastic surgeon who is board certified has decade of experience and a handful of positive reviews has mastered most plastic surgical procedures. To make quality assessment, we need quality information. That generally means at a minimum we need to see a complete set of proper before, and after pictures and know the timeframe of when your surgery was done. If one round of Liposuction didn’t give you a result, it’s unlikely that doing more of the same will. Whether the problem was that you’re not a good candidate for Liposuction or that your surgeon doesn’t have sufficient skill or that expectations were dialed in incorrectly we cannot tell you. Most likely it’s a combination of all three. Best, Mats Hagstrom MD