How to correct cobra neck deformity/platysma band show and how soon after overly aggressive chin liposuction? (Photos)

Question

How soon after overly aggressive chin lipo can I get fat transfer to correct platysma band show and cobra neck deformity? And how effective would this be in correcting both issues? Any other effective, long term options (not interested in temporary Botox) ? I am only 25 years old. All help is appreciated

Michael P. Morrissette, DDS, FACS · Answer

There is no required time to wait following the liposuction assuming it wasn't 2 weeks ago. I have treated this deformity with fat transfer with good results. In some cases, it will take several fat transfer sessions a few months apart.

Daniel Barrett, MD · Answer

Dear Ktdec5,
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

Jason Emer, MD · Answer

A combination approach would give the most improvement. Nonsurgical options such as Kybella, PDO NovaThreads, and Ultherapy do well in combination for skin tightening, but the results are mild compared to surgical options.

I would recommend a VASER Hi-Definition Liposuction with ThermiRF, Renuvion (J Plasma) and InMode BodyTite to contour and tighten the chin and neck. A neck lift can be performed at the same time, if you're a good candidate. I suggest seeing a board-certified cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer.​

Darryl J. Blinski, MD · Answer

Sorry for the overly aggressive liposuction preformed. Was it just liposuction only or an energy devise associated with the liposuction? I recommend fat transfer to the areas using nano & micro grafts in multiple sessions about 3-6 weeks apart. Expect fees after all done in the $30,000 ranges.

Mats Hagstrom, MD (license on probation) · Answer

I continue to answer questions on real self and on a daily basis I announce that Delivering consistent high-quality Liposuction results is more difficult than most people think and the importance of properly vetting plastic surgeons before committing to this permanent and more or less irreversible procedure.

Your situation is complicated and difficult to correct.

You didn’t include how long ago the procedure was done but I recommend slowing down as much as possible and give everything proper time to heal including letting scar tissue mature before doing anything and in between future interventions.

The problem is that almost all if not all the fat was removed when it shouldn’t have been.  It would seem that fat transfer would be a logical choice to fix this problem.  The problem is that in order for fat graing to work the grafted fat has to have some form of host tissue to support the graft.  this means that in the thinnest areas that need the graft to survive the most the graft will survive the least and in surrounding areas where there may be slightly more fat the fat graft will survive better. This is what makes restoring previously removed fat from Liposuction using grafted fat so difficult.

One option I’ve thought about for this situation but have not tried it to cover the area in a single layer of aloe derma or other cadaveric dermal product.  I simply don’t have experience to recommend if that could be a viable option.

There are very complex reconstructive operations that are typically outside the scope of cosmetic surgery that could replace tissue such as a Lipo/dermal  free flap.  These are not actual suggestions but concepts that could work to fix the problem.

Probably the best option is conservative grafting of small amounts of fat recognizing that a single session will be insufficient to fix the problem and that to get this to be corrected may take multiple procedures.  The best way to move forward is to schedule a lot of in person consultations.

Look for very experienced and talented plastic surgeons who have many years of experience especially with that transfer and in reconstructive surgery as well.

Avoid providers who tell you that this can easily be fixed or offer you simplistic remedies especially using energy-based devices such as VASER Liposuction.

My best guess is that it will require four or more sessions of fat grafting to build up a fat layer that could eventually be correctly contoured.

There is no simplistic or easy solution to your problem.

Consider the outcome and your perceived belief that the provider was probably fairly talented and recognize that revision work is technically many times more difficult.

That you tell you the caliber of plastic surgeon you need to find to move forward.

There is no substitute but to interview a lot of plastic surgeons to find someone who has the skill and experience and that you will most likely trust to do more surgery.

Best,

Mats Hagstrom MD

How to correct cobra neck deformity/platysma band show and how soon after overly aggressive chin liposuction? (Photos)

Answers (5)

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