Is this prolonged swelling? Will it improve? (Photo)

Question

I had chin lipo, facetite and platysmaplasty 7.5 months ago. I was told it can take up to a year for swelling to go away. I am wondering if this is the case. The side of my chin I have a pocket of swelling that I can see on my profile. When I tilt my head down there is a visible section of swelling or fat in that area. When I was recovering I had a huge chunk of hard swelling and I feel like this is where the edge of that was on that side.

Matthew Schulman, MD · Answer

It is true that swelling can last a long time, but the only person who can really tell you what is going on is your surgeon. I recommend following up with your surgeon. I get that it is easy to post on here and many docs may chime in with there advice, but the only reliable advice would be from the person who did the surgery on you.

Daniel Barrett, MD · Answer

Dear Piper1818,
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

First and foremost to make an assessment on the outcome of the surgical procedure we need to see proper before and after pictures.
If you don’t have before and after pictures then ask your surgeon to forward the ones they took.
Swelling after liposuction subsides relatively quickly and most people have a good understanding if you’re gonna be happy with the results or not by six weeks.
My three month results are final and there is no further swelling. Waiting further is not going to change the results.
If anything the face and neck heals faster than other parts of the body the results are probably final by about eight weeks for most patients.
The only exception is the color of the scar at the incision site which can take over a year before they stop changing.
95% of people will seek chin and neck liposuction have a facial skeletal imbalance with an under sized mandible.
The primary problem is almost always skeletal with a normal fat distribution.
Since fat removal isn’t treating the problem on the partial improvements are generally achieved.
The procedure can lead to spanning results especially in chubby young individuals who have a lot of fat to remove.
Delivering consistent quality liposuction results is more difficult than most people believe. The number of providers who can accurately assess and then deliver consistent results based on showing numerous before and after pictures of previous patients with a very similar facial characteristics all on a consistent regular basis is actually quite rare.
Personally I’m not a big fan of sub dermal heating skin tightening technologies and believe they deliver very little in terms of benefits to the patient.
They are primarily sales tools for providers to differentiate themselves from the rest of the crowd.
In the end there are only two variables determine what quality results look like. They are the candidacy of the patient combine with the scale and experience of the provider.
These are the only variables that matter.
Your pictures are limited but based on those it appears your treatment was heavy-handed and aggressive.
When you flex your neck your contracting skin and contracting skin will create a certain contour.
This may have changed from after the procedure.
 We do not judge results based on what I’m looks like when the skin is contracted like with a Abdomen looks like in a sitting position after a tummy tuck.
Results are generally judged with a head and a neutral position just like how you were before and after pictures were most likely taken.
The goal is to differentiate if your fat distribution is even and smooth. There’s a little someone can do about how your skin drapes.
It’s not possible to give you an accurate assessment based on the information provided.
At a minimum you need proper before and after pictures but to get a good assessment you need an in person consultation.
Plastic surgeons are notorious bunch for blaming poor results and patience especially time and the swelling.
The lack of taking ownership for the outcome is unfortunately more likely the norm rather than the exception.
Revision work is many times more difficult than primary Liposuction and there is evidence that your procedure was already done and I highly aggressive manner.
For that reason you should be very careful moving forward with having a revision with your current provider unless their proposed plan seems very straightforward and makes sense to you.
Things can always be made worse from revision work and consider that revision work is many times more difficult and primary work if somebody didn’t get the results correct the first time it’s unlikely they will a second time around.
That said sometimes if it’s simply a matter of removing more fat from one side and that should generally be done by the person who did your first procedure.
Whether you have faith in your provider or not and or are willing to pay for another provider to do the revision work it’s a decision and plan you will have to come up with.
It’s always a good idea to get multiple consultations before having any procedure.
Before having any surgery I recommend patients have at least five in person consultations. During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patient to add similar facial or body characteristics to your own depending on what procedure you’re having.
Being shown a handful of preselected images representing the best results of the providers career is totally insufficient to get a clear understanding of what average results look like or how many of these procedures they’ve actually performed.
I would be very apprehensive of being one of the first patients if a provider is using new equipment.
An experienced provider should have no difficulty showing you at least 50 that’s a before and after pictures of commonly performed procedures.
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that didn’t turn out as well as stay at home for.
Ask them about the revision rate and what the revision policy is.
Familiarize yourself with quality before and after pictures and make notes during each consultation regarding the quantity and quality of the before and after picture shown to you.
Ask providers to only show you pictures of previous patients who had very similar characteristics to your own.
Candidacy it’s probably as important as the skill and experience of the provider when it comes to deliver in consistent quality outcomes so it’s important to compare only patients who have similar candidacy for the procedure.
You should also take notes about the overall thoroughness how are you to consultation and take your time when it comes to choosing a provider.
If you’re not certain you found the best most qualified and experience provider for your procedure and wait and schedule more consultations.
For revision work it’s the same process but don’t expect providers to have as many before and after pictures of revision work since that is not as common.
You can either follow up with your provider or schedule second opinion in person consultations.
Avoid virtual consultations whenever possible.
I also recommend people avoid traveling long distances for elective surgical procedures.
For a second opinion consultations come prepared bringing with you copies of all before and after pictures and a copy of your operative report. These are all available from your current providers office if you request them.
Best,
Mats Hagstrom MD

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