What to do about permanent disfigurement from chin lipo? (Photo)

Question

Had a chin reduction. On surgery day, my PS decided I needed chin lipo and did it at no addl cost. I’m slim & didn’t need it but agreed, thinking it was low risk. Now I’m left permanently disfigured at 25yo as too much fat was removed. My platysma bands & submandibular glands are exposed, have abnormal hollowing, and MMN damaged. Was not given a consent form/made aware of any of the risks. Had I known, I would’ve never agreed. PS is being dismissive/uncooperative. What should I do? Legal action?

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

Mats Hagstrom, MD (license on probation) · Answer

Handling this on a professional level is up to you and how you want to deal with it. Typical options include patients negotiating for some type of refund or talking to a malpractice attorney about a lawsuit.

In your case you have a low likelihood of successfully suing the plastic surgeon for malpractice since you agreed to the procedure.

If Liposuction was not discussed before and is not on the consent form then you have an excellent case for suing the physician for operating without consent.

Unfortunately operating without consent it’s often not covered by doctors male practice insurance policies so if you did that you would be suing the surgeon himself not his malpractice insurance company.

I’m no legal expert but at least that’s my understanding.

It’s generally always better to work out something that’s fair and reasonable for both patient and physician.

Your doctor was trying to help you and offered you a procedure without even charging you for it. His intention was to make you look better and to help you and he even offered to do it at no cost.

Obviously after the fact it doesn’t seem so generous but at the time it sounds like it was a very nice thing to offer.

In regards to correcting this there are no easy solutions.

Liposuction is a permanent and more or less irreversible procedure.

For poor outcomes revisions typically include revision liposuction, grafting fat sometimes called fat transfer or converting the procedure to a skin tightening procedure like a neck lift.

None of those are great options in your case but of the three fat grafting is probably your best choice.

The problem with grafting fat is that in order for the grafted fat to survive there has to be host tissue to support the graft.  In the most over treated areas is where you have the least amount of host Tissue and Grafted fat will survive the least.

For that reason only a small amount of fat will survive and only conservative amounts should be grafted during any single session.

If successful with even a small amount of fat surviving a second round a fat transfer can be done gradually building up the fat layer until there is a sufficient amount of fat to correct the problem.

Delivering consistent high-quality Liposuction results is more difficult than most people believe.

Considering dad Revision Work is many times more difficult than primary Liposuction it goes without speaking the importance of finding the most experienced and talented provider for Liposuction and fat transfer in your community.

To find the right person to work with and have that person be willing to take on your case is going to be challenging and take a lot of work.

Your best option is to start scheduling lots of in person consultations.

For in person second opinion consultations patients should bring a copy of their operative report and proper before and after pictures. If you don’t have before and after pictures then ask the surgeon who did your procedure to forward the ones they took.

During each consultation ask each provider to show their entire collection of facial fat grafting before and after pictures.  specifically ask if they have before and after pictures of Revision Work of the face and neck especially restoring fat from excessive Liposuction.

Taking on other doctors poor outcomes can be undesirable work. Patients typically take a substantial amount of time, have lots and lots of questions including follow up emails, phone calls second appointments etc. etc.

In the end many patients end up not having surgery and the surgeon doesn’t get compensated for all the time they spent counseling the patient.

For this reason it is reasonable to compensate plastic surgeons for their time when doing second opinion consultations.

If you find plastic surgeons who think this is easy, can be fixed with a single procedure or can be fixed using some energy device such as VASER you should probably look elsewhere.

When it comes to doing fat transfer for these type of cases the smallest change comes after the first procedure while the surgeon is trying to build up the fat layer.

This can leave patients with an even greater lack of faith since they’ve already had a bad experience with a plastic surgeon in the past.

It’s difficult to work and you should expect correcting this to take several procedures.

Don’t be in a hurry and be highly selective of who you work with then stay with that person and let them finish.

Best,

Mats Hagstrom MD

What to do about permanent disfigurement from chin lipo? (Photo)

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What to do about permanent disfigurement from chin lipo? (Photo)

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