Chin lipo revision to fix dents and unevenness? (photo)

Question

I’m 45yrs old. I have chin lipo a year ago. I was left with dents across my face and uneven in the chin area. I need advice if a revision or a different procedure would help me?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thanks for sharing your story and photos—they clearly show some contour irregularities and asymmetry under the chin and along the jawline. At one year post-op, your result is considered stable, so it’s a good time to evaluate options.

These dents and unevenness may be due to over-removal of fat, residual fat, or scar tethering where the skin sticks to deeper tissue. At age 45, reduced skin elasticity can also exaggerate these effects.

Potential Solutions:
Fat Grafting
This is often the best option to soften dents and fill hollow areas. Fat is taken from another part of your body and grafted into the areas of irregularity, helping to restore smooth contours.
Revision Liposuction
If certain areas were undertreated, precise, small-volume liposuction can help balance things—though it must be done carefully to avoid overcorrection.
Microneedling with RF (e.g., Morpheus8)
For surface-level dents or mild tethering, this can stimulate collagen and improve texture, especially if skin tightening is also needed.
Subcision
In deeper scar-tethered areas, this minor procedure can release tight fibrous bands, often done with or followed by fat grafting.

A consult with a board-certified plastic surgeon experienced in facial contour revision will help determine what’s causing the irregularities—volume loss, tethering, or skin laxity—and create a custom plan. Most often, fat grafting combined with light skin remodeling yields excellent results.

You’ve done the healing. Now it’s about fine-tuning—and you’re absolutely on the right track.

All the best,
Earl Stephenson, Jr., MD, DDS, MBA
ESJ Aesthetics

Eric M. Joseph, MD · Answer

Based on your photos, it appears that the irregularities extend up onto your face. We do not advocate facial liposuction at all. Neck liposuction is helpful for removing unwanted deposits of neck fat, and for improving upon somebody's jawline. Perhaps you still have fat in your neck and a well performed neck liposuction may be considered for an improved contour and jawline, depending on your examination. Thank you so much for this question. Sincerely, Dr Joseph

Anna Chacon, MD, FAAD · Answer

Chin liposuction can sometimes result in unevenness or dents, which can be concerning. Here are some considerations and possible options for addressing these issues:

Assessment by a Professional:

Consultation: It is important to consult with a board-certified plastic surgeon or dermatologist who specializes in facial contouring. They can assess the extent of the irregularities and recommend the best course of action.
Underlying Causes: Determining whether the dents are due to residual fat, skin laxity, or scar tissue is crucial for selecting the appropriate treatment.
Possible Treatment Options:

Revision Liposuction: In some cases, additional liposuction can help to even out the contour by removing any remaining uneven fat deposits.
Fat Grafting: This involves taking fat from another area of the body and injecting it into the dents to smooth out the surface.
Non-Surgical Treatments: Options such as dermal fillers might be considered to temporarily fill in the dents and create a more even appearance.
Skin Tightening Procedures: If skin laxity is contributing to the unevenness, treatments such as radiofrequency or ultrasound therapy may help tighten and smooth the skin.
Considerations:

Healing Time: Be prepared for additional recovery time if undergoing revision surgery or other procedures.
Realistic Expectations: Discuss with your surgeon what results are achievable to ensure your expectations align with possible outcomes.
Choosing a Provider:

Experience and Expertise: Select a provider with proven experience in facial contouring and revisions to ensure the best results.
Review Before and After Photos: Look at the surgeon's previous work to gauge potential results.
Ultimately, a thorough evaluation by a qualified professional is essential to determine the most suitable approach for correcting dents and unevenness after chin liposuction.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality liposuction results is more difficult than people realize.
The number of plastic surgeons who approach mastery of this kind of work is in reality quite small.
It’s hard enough to take an even fat layer, reducing it, and leaving it even.
 Taking an uneven fat distribution and making it even is many many times more difficult.
Any attempt at improving the outcome can make things worse unless you’re in the hands of an exceptionally talented provider.
Even the hands of someone who is very good at this kind of work Only partial improvements may be possible.
It’s easier to get quality Liposuction results and people who are excellent candidates for Liposuction.
The number one criteria for being a great candidate for Liposuction is having moderate thick layers of subcutaneous fat with tight skin.
Skin laxity is probably the number one reason why patients fail to be great candidates for Liposuction.
Finding the right provider in an ocean of self promoting plastic surgeons, all claiming to have the necessary skills is very difficult as well.
To start with we need quality information and this always means having access to a complete set of proper before and after pictures as well as your operative report.
You can get these from your current providers office by requesting them.
 It’s also important that you follow up with the surgeon who did your procedure and let them know your unhappy with the outcome.
That surgeon should stop leaving people disfigured.
There’s definitely room for improvement, but this requires working with an exceptional provider who has some mastery of Liposuction, including revision work.
To find the right provider generally requires having multiple in person consultations.
I highly recommend people avoid virtual consultations.
Bring a complete set of proper before and after pictures and a copy of your operative report. During each consultation, ask providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar characteristics to yourself.
Highly experienced providers should have access to more before and after pictures then you have time to look at it during the consultation.
It is very important that you spend a significant effort reviewing before and after pictures because it’s your responsibility to vet the provider in regards to the skill and experience.
If you fail to properly vet plastic surgeons, then you are at risk for having poor outcomes.
In my opinion, people are generally not very good at selecting providers.
People make far too many assumptions.
I wish I could be more optimistic, and there is definitely room for improvement, but this is going to require finding a provider who shows mastery of this type of work.
The decisions will be your own.
Unless you feel very comfortable, you’re in the hands of someone who is truly exceptional when it comes to Liposuction skills it may be a good idea to hold off on revision surgery.
You need to confirm specifically that they have mastery and in regards to liposuction of the chin and neck. There’s no shortage of people claiming to have the skills needed so it is your responsibility to confirm that this is true.
Best,
Mats Hagstrom MD

Chin lipo revision to fix dents and unevenness? (photo)

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