Neck bands after chin lipo - does my condition have a solution? (Photos)

Morpheus 8 is 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

Thank you for your question and photos. I’m sorry that you’ve developed neck bands after your liposuction procedure. Neck banding tends to become more visible as the skin becomes thinner, either as a result of aging or fat loss. When injected directly into the neck bands, Botox can minimize the appearance of horizontal lines and prevent the banding from getting worse over time, when an appropriate dosage and injection schedule are maintained.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or expert injector. They will be able to review your treatment history, evaluate your concern, and suggest the best treatment option for you.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Hello @Persistent661344, thank you for your question. To make an informed recommendation, more information is needed. A consultation is vital to establishing a surgical plan that meets your needs, meets your expectations, and takes into account what is realistically possible. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Delivering consistent quality liposuction results is more difficult then most people think.
Being board certified in plastic surgery with a good reputation and years of experience does not mean someone has mastered liposuction. The number of providers who do liposuction well on a consist basis is in a minority.
Liposuction is a permanent and basically irreversible procedure.
The neck needs to be treated with caution. I try not to be critical of others because we have all had outcomes that didn’t turn out as well as we had hoped. That said your provider failed to remove fat at the jawline so you didn’t get the jawline definition that was possible from the procedure.
Improving the outcome at this point is going to be challenging.
Recognize that revision work is far more difficult than doing primary procedures. I see two possible options for improving your outcome. Neither is it easy nor will it make things perfect. One approach would be adding fat though a series of careful fat transfer. Fat transfer is particularly challenging when most of all of the previous fat has been removed because it leaves patients having vertically no host tissue to support the grafted fat. for this reason, grafting needs to be done carefully and conservatively understanding that it may take several sessions to build up a subcutaneous fat layer that was inappropriately removed.
The other approach is to deal with the platysmal bands directly, which there are procedures designed to do including injecting them with Botox.
The third option for improvement is doing revision liposuction carefully taking out a very small amount of fat right at the jaw line which your provider missed and is what gives such great results when this procedure is done correctly.
Because Liposuction is a difficult procedure to do, and the number of plastic surgeons who are truly excellent at this procedure is few patients should be far more selective than they ever thought necessary when it comes to choosing a provider.
This becomes even more important for revision work since revision work is many times more difficult and challenging than primary work.
Defined the best provider I recommend patient start by having multiple in person consultations. The more consultations you have the more likely you are at finding the best provider. For procedures, like Liposuction, where there is such a divergence in skill among plastic surgeons, I suggest patient start by having a minimum of five in person consultations before considering scheduling surgery.
During each consultation, ask each provider to open up their portfolio and show you before, and after pictures of previous patients, who had similar face and neck characteristics to your own. An experienced provider should have no difficulty showing you with the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of a providers career or showing pictures of patients who have different Characteristics such as different age, different amount of fat or different facial structure is insufficient to get a clear understanding of what average results look like in the hands of each provider or what your results are likely to look like.
Ask providers to show you a variety of outcomes, including excellent results, average results, and results that did not turn out, as well as they had hoped for. As providers specifically about revision rates and revision policy.
Providers may be apprehensive to show you anything but their best pre-selected images, which are usually collected in a “show and tell” collection.
Patients should come in to consultations being familiar with what quality results look like. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures showing up. Ideally patients should have a grading system for quality outcomes, and set a score for the results of each provider during the consultation. Five consultations is a good place to start, but may not be sufficient to find the best provider. This may be the case for someone seeking revision work. Revision work, especially if done, using revision liposuction (removing more fat) can easily make things much worse.
The best providers for revision work are generally the same providers who do the best primary procedures. The only exception would be if fat transfer is your best option, in which case you need to make sure that the provider has mastered both chin/neck Liposuction and fat transfer procedures.
In the end, there are only two variables that determine quality cosmetic surgery outcomes. The first is patient candidacy, and the second is the scale of the surgeon.
I’m sure this experience has been very upsetting. I go on this website on a daily basis trying to steer people in the right direction when it comes to choosing providers which, as you know, now is incredibly important in order to maintain, consistent high patient satisfaction.
The truth is a lot of plastic surgeons are not good at Liposuction, and many of them shouldn’t be doing liposuction procedures.
Mastering this procedure takes a total commitment to excellence, being critical of your own work, decades of experience, and doing thousands of cases.
Best,
Mats Hagstrom, MD