Why doesn’t lipo or anything work for me after fat transfer in jowl area?

Question

I 2017 I asked for filler in the pre jowl sulcus. The surgeon convinced me to do a fat transfer but put the fat in the jowl area instead. Since then I’ve had accutite, 2 rounds of lipo, kybella & Agnes radio frequency & NOTHING has worked. I’m so discouraged & disappointed. Not only with getting no results but the money I’ve spent. Why can’t this fat be removed?

Zoran Potparic, MD · Answer

Without photos or in person evaluation it would be very difficult to give you good advice. Possibly a combination of jowl reduction by means of liposuction and a sulcus augmentation may work? In person consultation with another plastic surgeon would help.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you’ve had more than one procedure, then we should ideally see before and after pictures of each of the procedures you’ve had previously.
 There are generally two variables that determine the outcome of most plastic surgery operations. The first is the patient candidacy for the procedure and the second is the skill of the provider.
Fat grafting is fickle, precise, unpredictable, and unforgiving if patient don’t like the outcome.
For this reason Fillers are in my opinion preferable. The pre-jowl sulcus is a tricky place to work because there’s an important branch of the facial nerve that goes through the area.
Facial aesthetics can be a complex topic, and sometimes fat manipulation isn’t the correct treatment because the inherent problem isn’t based on fat distribution.
Without seeing pictures, we can’t really begin to make an assessment.
Provider selection is by far the most important variable, since it’s the only variable patients have much control over.
I suggest all patients consider having multiple in person consultations before considering any permanent procedure.
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 the same Characteristic.An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients for commonly performed procedures.
Revision work is more complex and more difficult than primary procedures.
Consider reposting with proper before and after pictures. If you don’t have before, and after pictures, then ask your previous providers to forward the pictures they took.
 Whenever seeking a second opinion, consultation should come with complete sets of medical records, or at least operative. Reports from previous providers.
Best,
Mats Hagstrom, MD.

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