Uneven lipo results? Left side of face is sagging (Photo)

Question

I had chin lipo done 5 weeks ago- she also did my jaw and neck area. I’ve noticed since the procedure that the left side of my face looks larger and sags more than my right. I’m worried that it won’t even out since I’m already 5 weeks out? She says it will- but I don’t trust that she’s telling me the truth I feel like she’s just trying to dismiss me. Also curious is the lumpy/wavy area underneath my chin will smooth out or is it permanently lumpy?

Randal Haworth, MD, FACS · Answer

It's common for there to be some swelling and asymmetry following chin liposuction and facial contouring procedures. Swelling can take several weeks to subside, and it's not uncommon for one side of the face to appear larger or more swollen than the other during the initial healing phase. However, it's important to have a follow-up consultation with your surgeon to address your concerns and have a professional assessment of your specific situation.

At five weeks post-surgery, you are still in the early stages of the healing process. While some improvements may be visible by this time, it's possible that you may still have residual swelling and asymmetry that will gradually resolve over the next few months. It's important to be patient and give your body time to heal.

Regarding the lumpy/wavy area underneath your chin, it's possible that this could be a result of swelling, scar tissue, or uneven fat removal. In many cases, these issues can improve and smooth out as the healing progresses. However, if the lumpy/wavy appearance persists beyond the initial healing phase, it's advisable to discuss this with your surgeon.

If you feel uncertain or uncomfortable with the responses you receive, you may consider seeking a second opinion from another qualified plastic surgeon to address your concerns and ensure that you have all the information you need for peace of mind.

I hope this helps,
best of luck !

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

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.

David Tuggle, DDS · Answer

I always recommend to my patients to use a jade roller and heating pad with nightly aggressive massage to smooth out the neck post surgery, this often times takes care of any unevenness. I would wait 6 months to see the full results, many liposuction patients continue to see results months after the initial surgical swelling. Sometimes patients require a little lipo touch up if more was removed on one side than the other.

Camille Cash, MD · Answer

It is still too early to judge your results.  Liposuction can worsen or lead to skin contour irregularities or laxity.  You can consider Morpheus8 treatments if that should occur.  Continue to follow up with your surgeon as scheduled.

Mats Hagstrom, MD (license on probation) · Answer

I usually tell people that by six weeks they have a pretty good idea of what liposuction results are going to look like. Final results take three months.
Delivering consistent quality, liposuction results is more difficult than most people realize. The number of plastic surgeons who truly mastered this procedure isn’t a small minority. Liposuction is a permanent and irreversible procedure. No interventions or revision work should be done within the first six months so the correct thing to do at this point is simply wait and then get a proper assessment to see if there may be opportunities for improvement.
To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took. Without knowing what you look like before hand, we can’t assess your candidacy for the procedure. This is especially important when it comes to issues of asymmetry, since the human face is highly asymmetrical on almost all people.
There is a significant variation in outcomes, based on variance in skill and competency in liposuction among different providers. Mastering this procedure is far more difficult than most people recognize. Being bored, certified in plastic surgery with years of experience in an overall good reputation does not mean that somebody has mastered Liposuction. 
The impact of the procedure can give stellar results, but can also lead to undesirable outcomes that are very difficult to correct.
For this reason, I suggest patients be be more selective when choosing providers for liposuction. I suggest most patients have multiple in person, consultations with local board-certified plastic surgeons before choosing a provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients with similar facial or body characteristics to your own. Look very carefully at the results to make sure there are no skin contour irregularities in any treated area. For reference an experienced plastic surgeon should have no difficulty showing you 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 is insufficient to get a clear understanding of what results look like in the hands of each provider or how many of these procedures they’ve actually performed. 
There’s no correct number of consultations patients need to have to find the right provider. Considering how much variation there is in Liposuction skills I suggest patient start by having at least five in person consultations before choosing a provider.
The time to be critical of plastic surgeons is in the consultation or vetting process before you schedule surgery. I recognize that you already had the procedure. Revision work is many times more difficult than primary Liposuction. This is especially true when the first procedure was done aggressively and too much fat was removed. 
The process of finding the best providers for revision work is generally the same as finding the best providers for primary procedures. The exception would be if fat transfer is needed to improve the outcome, in which case providers need to be vetted for their skill in fat transfer procedures.
When it comes to revision work, my best suggestion is to take your time and not rush into any decision.
Generally speaking, the first procedure is the best shot at getting a quality outcome. After the first procedure, things become far more difficult, and the chance of getting a quality outcome, especially if done by the same procedure goes down.
If providers don’t have sufficient Liposuction skills and are pressured to do revision work after doing an overly aggressive primary procedure, patients can be left worse from revisions.
Best,
Mats Hagstrom, MD

Uneven lipo results? Left side of face is sagging (Photo)

Answers (6)

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