What treatment would help ripples under the chin from a bad liposuction? (Photo)

Question

I had a chin implant 10 years ago and he surgeon did a liposuction under the chin. The implant was wonderful but I have ripples under the chin. What treatment would help me?

Thomas P. Sterry, MD · Answer

Gee, I'm sorry about that.  It appears that the skin in the neck area is going to have to be removed.  A neck lift can help you with that.  Done well, it will take about 3 hours and will leave you with a nice, smooth neck line that is well defined and elegant.  That said, in these cases you might want to consider combining it with a lower face lift because a lot of the same work and incisions will be necessary.Good Luck!

Michael P. Morrissette, DDS, FACS · Answer

Unfortunately the skin in this area will need to be undermined and removed via a necklift. The area is too large for effective fat grafting. Direct excision of skin is also a possibility, but this can leave an unsightly scar. Conventional necklift is your best option.

Dallas Buchanan, MD · Answer

Thank you for your picture and questions. This type of appearance is usually the result of over-aggressive liposuction in the neck which results in scar adhesion to the underlying muscle and the skin. This is usually going to require a neck lift to fix and there may also be a role for scar release and fat grafting in the area. Discuss with a local plastic surgeon who is board certified by the American Board of Plastic Surgery.Best of luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Sagar Patel, MD · Answer

It is difficult to tell from the picture but it does look like the skin has some abnormalities from ovver aggressive liposuction. A neck lift would take about 3-4 hours and cost ~7000. This might be your best option to correct it.

Bruce E. Katz, MD · Answer

Thank you for your question, if you are looking for a minimally invasive procedure I would consider Accutite. Accutute is the newest form of precise skin tightening. The AccuTite is the smallest minimally-invasive radio-frequency contraction device with the most number of clinical studies and peer-reviewed publications backing its safety and efficacy. Patients who need skin contraction now have a new solution that can be in an office setting, in less than 15 minutes, without excisional surgery. I suggest an in-person consultation with a board-certified dermatologist to go over your options. Best of luck!

Darryl J. Blinski, MD · Answer

Without in person examination based solely upon 1 posted photo I might recommend aggressive full open neck lift to re drape the irregular skin resulting from over aggressive lipo. Fee ranges from $8,000-$15,000.

Mats Hagstrom, MD (license on probation) · Answer

it's unfortunate that your surgeon was so aggressive with the liposuction.  Poorly performed liposuction it is difficult to correct and this becomes more so when patients have been over treated.  I'll grow through some procedures that might help.   1. Fat grafting or fat transfer It would seem logical that the treatment for having too much fat removed would be to replace it with fat transfer. Fat grafting and fat transfer are two different terms for the same procedure.  The problem with trying to graft fat in the area we lost the fat from the liposuction is there is no host tissue to support the graft.  You can't graft fat into the skin and grafting the fat into your platysma muscle will not correct the problem  you're now skin and muscle and there's no tissue in between to give a blood supply to fat graft if placed in that area. Small amounts of fat can survive but the procedure would have to be repeated multiple times probably three or four to get a real results.  Overgrafting simply leads to a higher percentage loss of the grafted fat. I would say don't choose this option 2.  Direct skin excision. A neck lift can be done in one of two ways.  Skin it could be taken out right in the area where you have the defect with the procedure often called the cervicoplasty. This will leave a scar from your upper part of your neck to your chin. For people who form scars that are not that visible typically people with very light color skin The sky can fade out very nicely.  The net can be tightened by pulling skin from around the ears. This is more or less the same approach as a facelift. This procedure you would get scars around your ears and  passably into your scalp.  One advantage of this is really great facelifts can look incredible.  Obviously it is highly operator dependent so choose your plastic surgeon carefully.  Your picture does not show your fullface so I don't know if you would be a good candidate for a facelift in the first place. 3 placement of AlloDerm  AlloDerm is a cadaveric skin a product that is basically skin with all the skin cells removed. It's the collagen matrix that holds the cells of skin.  It's possible that doing open surgery on your neck and placing one or two layers of  AlloDerm could help give a little volume and potential have a layer between the skin and your  platysma muscle( large flat muscle that covers your neck).4. Breaking up scar tissue using VASER. I've seen plastic surgeons talk about doing this for other situations where people have been over treated with liposuction. I would stay far away from this option if someone offers it to you.  It would generate more scar tissue and it is unlikely to give you any improvements. ( my opinion only ) What should you do?  I think a direct skin excision just below your chin where the indentations are the worst  would be my first choice. This would entail undermining or freeing up the skin from the underlying muscle layer. Then remove enough skin so the skin drapes without forming the folds or creases you currently are showing in the picture. My second choice would be attempted fat transfer but only on a patient willing to undergo the procedure numerous times. I would not attempt fat transfer at the same time as a skin excision but would consider placing AlloDerm at the same time as doing the skin excision. The placement of AlloDerm would be a little experimental but in some ways trying to correct your chin is experimental because it's not something any plastic surgeon does on a regular basis. My last choice would be a complete facelift.  It could be my first choice if you were a great candidate for a facelift and wanted that procedure in the first place. I'm going by limited information so I'm going to assume that you haven't been shopping around for a facelift.  In regards to nomenclature a facelift and a neck lift can be the same procedure except for a cervical plasty which is the medical term for removing the skin directly in the chin area. Well, that was a fairly lengthy answer.  Have a few in person consultations with senior meticulous plastic surgeons. It is unlikely anyone will be able to show you before and after pictures of repairing a similar problem.  Best, Mats Hagstrom MD

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