What do you suggest for chin lipo revision for hardness & indentation? (Photos)

Question

12 months ago I got buccal fat removal and chin lipo. Both services were add-ons to stomach Lipo. Surgeon suggested the day of and I agreed. When looking straight my chin looks fine, but from certain angles you can see that I have a hard lump/indentation where my scar is at. It makes it look like an actual double chin. A friend of mine that works at a plastic surgeons office suggested a chin implant to gain volume in area. I was thinking a revision/more Lipo. Any recommendations?

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.

Daniel Barrett, MD · Answer

Dear lsand,
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

I’m a big fan of patients having proper in person consultations well in advance of having their procedure. I also believe patients should have multiple consultations to compare skill and experience to find the best provider for each procedure.
Adding facial work on the day of surgery hardly gives you the chance to vet that surgeon for that type of work and gives you no ability to compare results to other providers.
Liposuction and buccal fat transfer or permanent and irreversible procedures.
Your procedure was done aggressively and a substantial amount of fat was removed.
Taking out more fat isn’t going to fix poorly done Liposuction.
Your situation is now complex and difficult to improve upon.
You need to have a very clear understanding of what the underlying problem is and not just guess on what procedure is going to make it look better.
Start that process the way you should’ve started in the first place.
First and foremost to make an assessment with the proper before and after pictures. If you don’t have those then ask your surgeon to forward the ones they took. You should also ask for a copy of your operative report.
Once you have those you can begin getting a proper assessment and better understanding of what the problem is and possible revision options.
Do that by scheduling multiple in person consultations with other board-certified plastic surgeons in your community.
Come prepared for the consultation by bringing with you all of your before and after pictures and a copy of your previous operative report.
Your last picture really demonstrates how over treated your procedure was.
Delivering consistent quality liposuction results is more difficult than most people believe and this includes a substantial number of board-certified plastic surgeons.
Liposuction is permanent and irreversible. Collecting poorly done outcomes is very difficult and revision work is many times more difficult than primary work.
Patients should be very selective in who they choose to do revision work.
If it’s an implant was needed then that should i’ve been pointed out during a proper consultation before the surgery.
Personally I do not like changing the surgical plan on the day of surgery. Doing so shows a lack of thoroughness without a well thought through plan.
Before jumping into another operation I suggest you slow down the drain and get some quality assessments. when it comes to revision work things can go from bad to worse.
Good luck,
Mats Hagstrom MD

Joshua Jacobson, MD - Account Suspended · Answer

Hi Isand. In the picture your skin appears tethered down. This may be caused by a lot of scarring. If that's really the case, you may need to have some fat graft to the area. However, I can not be certain without directly examining it.I do not believe a chin implant will fix it.

Jeffrey E. DeWeese, MD, FACS - Account Suspended · Answer

It is hard to tell for sure without being able to feel the area but it looks like too much fat was removed near the scar and it is stuck down to the underlying muscle. I would suggest vigorous massage and possibly a triamcinolone injection by a surgeon familiar with injecting this kind of steroid into the face. If that doesn't work then a small fat graft may free the skin. More lipo would only make it worse. A small chin implant might take of the slack skin but your chin does not look particularly underprojected from what I can see in the photos.

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