Am I a good candidate for Chin Liposuction with Renuvion? Seeking a second opinion (photos)

Question

I am scheduled for this procedure and wanted to see what others thought.

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.

William Portuese, MD · Answer

From this photograph, you have significant fat deposits located above and below the platysma muscle in your neck. The majority of your fat deposits are located below the muscle. Liposuction can only remove the fat deposits above the muscle which will be minimally effective. You going to need a surgical neck lift with a platysma plasty to remove the fat deposits above and below the muscle to significantly improve your jawline.

Daniel Barrett, MD · Answer

Dear Gregarious299553,
it is hard to tell for sure without an examination. Based on your photo, it looks like you would benefit from chin liposuction. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
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

Most people seeking cosmetic surgery tend to be average candidates. A few are excellent candidate and some tend to be poor or non-candidates.
On a scale of 1 to 10 with 10 being an exceptional candidate and one being someone who should not have the procedure I would give you a 4.5
Before choosing an operation people should have a clear Understanding of what the problem is.
Recognize that Liposuction treats on the fat distribution so fat distribution needs to be the primary problem in order for Liposuction to get good results. my first-hand experience with Renuvion was not particularly impressive but I have colleagues who thinks it can’t be helpful especially on the neck. 
The primary underlying principle of problem is based on structure especially the shape and size of your mandible as it relates to your Maxilla. 
Almost 100% of people seeking this procedure have an under sized mandible or a mandible that lacks projection. almost universally people seeking chin and neck liposuction have an overbite dental occlusion. Profile pictures will almost always show an upper lip that has more forward projection than the lower lip. when the mandible has those characteristics the underlying platysma muscle drapes the neck in an oblique fashion causing a premature double chin, lack of jawline definition and premature jowls. 
If you do not have an abnormal fat distribution and fat is not really related to why the lower 1/3 of your face and neck have the appearance that they do.
Fat happens to be the easiest tissue layer to treat and so people sign up for Liposuction. Recognize that a treatment that does not address the primary underlying problem is going to give you a partial improvement at best. 
On top of this there is more variety in skill when it comes to liposuction and any other plastic surgery procedure.
Liposuction results vary more than any other plastic surgery procedure based on what surgeon does the operation. this means there are plenty of well intended well trained board-certified plastic surgeons with overall good reputation we’re not particularly good at Liposuction.
There are plenty who are great but the variation is there and patience need to be very careful in selecting a sufficiently skilled provider.
The skill of the provider is important not only regarding performing the operation correctly but also in making an accurate assessment including the ability to predict and demonstrate accurate results based on numerous before and after pictures of previous patients who had very similar facial characteristics.
Candidacy for liposuction results is based on the variety of factors. The first one is probably simply how much fat is available to work with and how much is that contributing to the problem. The second most important variable is skin laxity or loss of skin elasticities due to age.
Skin laxity or loss of skin elasticity due to age or weight fluctuations tend to lower someone’s candidacy for quality outcomes.
I sometimes describe ideal candidate for Liposuction as those who are “young tight and pudgy”.
To get a proper understanding of how skeletal structure affect facial aesthetics consider consulting with oral surgeons.
You may also want to consider alternative procedures that may be more effective such as a neck lift.
At a minimum I recommend any person interested in cosmetic surgery at least have multiple in person consultations to first and foremost get the most accurate assessment and secondly help vett providers to find the most talented and experienced provider.
Personally I recommend patient start with at least five in person consultations and consider having more and less you feel very comfortable you found the right provider.
Anybody who claims results will be improved because they have some certain device should probably be seen as a fairly major red flag. Plastic surgeons have the equipment they need to do their job. Quality result typically does not depend on the brand of equipment used.
When having in person consultations I recommend patient bring facial pictures taken the same way plastic surgeons take before and after pictures showing full frontal face and profile. It’s good to have pictures of your own face to use as a reference when comparing before and after pictures.
Ask providers to only show you before and after pictures of the previous patients who have similar facial characteristics to your own.
There’s no point in seeing impressive pictures of other patients who were excellent candidates if you do not have the same facial characteristics.
Candidacy and surgeons skill are probably equally as important.
I recommend patients ask providers to show as many pictures as possible of patients with similar facial characteristics showing excellent results, average results and results that did not turn out as well as they had hoped for.
Providers may be tempted to stick with their preselected “best of their career” “show and tell”. before and after picture portfolio. This however does not give the patient a good understanding of what average results will look like in the hands of each provider, tell them how many of these procedures they’ve actually performed or give a realistic representation of what your results will look like.
Providers may be apprehensive to open up your portfolios and show you the diversity of results you really need to properly vet the provider. My recommendation is to be an advocate for your own care and insist on being shown a sufficient number of pictures to make a well-informed decision.
For reference a highly experienced plastic surgeon should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like Chin and neck liposuction. Highly experienced surgeons will have hundreds or even thousands of before and after pictures of this common procedure.
Take careful note during each consultation noting the quality and quantity of before and after pictures. make a note of how many pictures the providers was able to show you a previous patient who truly had similar characteristics to your own face.
A quality consultation should not leave you with any questions about what type of results you will have from the procedure. Your candidacy should’ve been explain to you clearly and confidently.
You should’ve been shown example pictures of other patients who have very similar facial profiles with similar amounts of skin laxity and fat thickness. If this didn’t happen then you probably haven’t found the right provider.
My best recommendation is to continue having consultations until you feel certain you found the best provider which should leave you without questions or doubts with a pretty clear understanding of what the procedure can and cannot deliver as well as a good understanding of all appropriate alternatives.
Until you’ve achieved that it’s probably a safe bet to simply put on the brakes and slow down the train.
Schedule consultations until you feel very comfortable with your choice of provider and procedure.
Patients are typically not experienced in consulting with plastic surgeons. plastic surgeons on the other hand are highly experienced giving consultations.
The process can be intimidating and telling a plastic surgeon what to do when it comes to showing you the evidence you need to make a well-informed decision does not necessarily come natural.
Practice makes perfect in the more consultations you have the better you’ll be at the process.
Liposuction results are permanent and irreversible.
If done poorly the procedure leaves people disfigured.
I’ve already mentioned that Liposuction has more variation in outcomes than any other plastic surgery procedure based purely on who does the procedure and this includes well trained experienced board-certified plastic surgeons with an overall good reputation.
There are also exceptionally talented people out there but with this procedure the variation in skill and experience is greater than most.
You’ll be reminded of the outcome every single day for the rest of your life so I think taking the time to have enough consultations to confirm you found the best provider is justified.
Good luck,
Mats Hagstrom MD

Am I a good candidate for Chin Liposuction with Renuvion? Seeking a second opinion (photos)

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