Had chin liposuction twice and still don’t have the counter I want. Is it loose skin ? What procedure will be best? (photos)

Thank you for your enquiry and sharing your photographs.

The most likely explanation is that the volume under the chin is concentrated deep to the platysma muscles rather than under the skin. It is unlikely that with two episodes of liposuction you would not have reached the limit of what can be done safely. Because the skin of the neck looks smooth, I assume that your surgeon or surgeons have been very sensible in limiting the procedure to avoid damage.

It is possible to reduce more volume in the neck from the deep plane using the short scar technique since you do not have any skin excess to remove. It would however involve 3 cm scar under the chin.

This intervention is able also to define better the jawline contour.

There is a second layer of submental fat that is not removed by liposuction alone. I would recommend a platysmaplasty with removal of this second layer of fat. Simultaneously, any subcutaneous fat can also be removed. You are young enough with good quality skin that a necklift can be avoided.

Chin liposuction only addresses pre-platysmal fat (the fat between the skin and underyling muscle). It could be you have subplatysmal fat which is causing the contour problems. You need an inperson exam to determine the location of this fat. If the fat is underneath the muscle, this would require a small incision (2-3 cm) under your chin.

you needed a neck lift, and that can still be done which may include lifting the skin and/or removing some of the muscles in the neck. internal heating like facetite or renuvion should also be used.

most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus or pixel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift.  an early face lift /neck lift with or without buccal fat pad reduction can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done.


For facial slimming a combination of treatments are always needed.  Options include:
1. Buccal fat pad removal to reduce fat on the lower face
2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping.
3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender
4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined
5. early face/neck lift with platysmaplasty or maxillofacial surgery (bone shaving or implants) 

6. botox/dysport/xeomin on the neck for platysmala bands and neck tightening 


Always use at home EMERAGSKIN dermarolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten , cosmelan or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma.


See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Dear Citygirl17,
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

Evidently not enough fat was removed, so the solution is to to have another procedure and remove it.
I personally combine Precision laser liposuction for submental and neck fat removal and find it quite thorougly removes the fat as well as tightens the skin .
The procedure is done under local, three small access incisions, under the chin and below each ear, tumescent infiltration, laser treatment to melt the fat, liposuction removal of the melted fat, and then the laser is turned upward against the skin where the heat effect stimulates collagen and skin contraction which continues for six months.
A compression head dressing and foam on the neck is worn for 5 days or so, and the recovery is quite straightforward with little bruising.

Who or what specialty MD did the liposuction? Appears was SOOOOO conservative. Best to seek experienced boarded Plastic Surgeon. I would try it again. Fees in $5,000 ranges.

There are many different variables that contribute to each individual persons look or shape and contour of their Jawline and neck.

Bone structure is probably the biggest variable. This is especially true for those who have a mandible that is small in relationship to their Maxilla. this often presents and profile pictures with an upper lip that has more forward projection than the lower lip and may present with a dental overbite occlusion.

Other tissues to contribute to how this area looks include skin, subcutaneous fat, platysma muscle, sub put a small fat layer and salivary gland‘s.

Subcutaneous fat is only one layer that is reduced during Liposuction and for those who have all other tissue types being in a fairly ideal balance Liposuction can give good improvements. obviously who does the procedure has some impact.

When posting regarding the outcome of a procedure it’s better if patients post proper before and after pictures and if more than one procedure was done include before and after pictures of each procedure.

If you don’t have before and after pictures then you should ask your provider or providers for the ones they took.

If two rounds of liposuction have an ad delivered the results you had hoped for and then that may be a sign that subcutaneous fat may not be the thing creating the problem.

To get an accurate assessment I suggest scheduling a few in person second opinion consultations.

Best,

Mats Hagstrom MD