Should I consider a second round of chin liposuction? 31 y/o female, unhappy with results (photos)

Question

I’m a 31 year old female, I had chin and neck liposuction on July 11th 2024. I recently had my follow up and am very disappointed with the result as I expected the sub mental fat to be gone and have a more defined side profile. I also have lost a total of 25 pounds since the procedure. I am wondering if this a normal result, or if I will need a second round? At my follow up I was told I had a great result and that I should be happy with this. Would I benefit from a different procedure?

Bianca Knoll, MD · Answer

thank you for posting your question. I think there are several options to consider, depending on the desired outcome you whish for. First, to repeat the chin liposuction. There are different devices and techniques out there. In case you are looking for a more  refined result, a different approach might be considered after  having consulted and discussed with your surgeon. Some patients benefit from a combination of platysmaplasty, contouring of the deep and superficial fat compartments, chin ptosis correction and contouring of the chin soft tissue pad.  Although this sounds a lot, a little of everything goes a long way and can be comfortably performed under local anesthesia. Only a  small incision is needed. I hope this helps

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs. To some extent, the outcome depends on whether the layer of fatty tissue under the skin is still significant and whether liposuction is feasible while retaining enough fat to ensure a smooth and natural contour. Excessive or aggressive liposuction under the chin can result in contour irregularities and vertical banding, which are unsightly and can detract from the overall quality of the result.

An anterior neck lift, in contrast, addresses the deeper layers of fatty tissue and can reduce volume in the submental area, including contributions from the digastric muscles and the lower portion of the submandibular glands.

In the first instance, I recommend discussing your concerns with your surgeon. If they determine that liposuction has already achieved its maximum potential impact but you still desire further improvement, then a deep plane approach to the neck may be the most appropriate next step.

Lexie Wang, MD · Answer

With the surgery still only having been a few months ago, you definitely probably still have some swelling that needs to work its way out. I would eval with your surgeon and see if they can tell that because usually it's pretty obvious on the exam if there's leftover fat vs. normal lymphedema post surgery.

Michael P. Morrissette, DDS, FACS · Answer

The weight loss will cause extra skin but I think that you need a different procedure. You have a very profound submental crease, and I prefer to perform a platysmaplasty with fat transposition of the sub-platysma fat to fill in the crease. This will give you a sharper jawline and improved cervical mental angle. At the same time the platysma  muscle is tightened in the front.

Eric M. Joseph, MD · Answer

What's nice about neck liposuction is that some people get amazing results that can mimic a facelift, neck lift. Sometimes, results can be less than what is expected. This can be due to your neck fat being located in a deep plane, or possibly that there was too much fat left behind in the subcutaneous space. If the latter is true, depending on your examination, repeating neck liposuction may be worth considering. I hope this is helpful, and thank you for your question. Sincerely, Dr Joseph

Anna Chacon, MD, FAAD · Answer

It's understandable to feel disappointed when the results of a cosmetic procedure don't meet your expectations. Given that you had chin and neck liposuction in July 2024, it's important to consider that full healing and the final results can take several months to manifest. The skin and tissues need time to adjust to the changes after liposuction, and sometimes improvements continue over several months.

Since you mentioned losing 25 pounds since the procedure, this significant weight change can also affect the appearance of your results. Weight loss can sometimes lead to more skin laxity, which might make the area appear less defined than expected.

Here are a few points to consider:

Healing Time: Ensure that enough time has passed for the final results to be visible. It often takes 3-6 months to see the complete outcome of liposuction.

Consultation: If you're still unhappy after allowing sufficient healing time, consider seeking a second opinion from a board-certified plastic surgeon or a dermatologist with experience in cosmetic procedures. They can assess whether a second round of liposuction or an alternative treatment might be beneficial.

Alternative Treatments: Depending on your specific situation, other procedures such as skin tightening treatments (e.g., radiofrequency or ultrasound therapies), Kybella injections, or even a neck lift might be more appropriate to achieve your desired outcome.

Realistic Expectations: It's important to have realistic expectations and understand that the goal of cosmetic procedures is improvement, not necessarily perfection.

Ultimately, a detailed consultation with a qualified professional who can review your individual case and photographs will provide the best advice on whether further treatment is necessary or beneficial.

Darryl J. Blinski, MD · Answer

Based on your posted photos, I would recommend a round two liposuction with end treatment or chin, liposuction treatment and a mini neck lift option. Best virtual consult with. Expect fees to range from $5000-$10,000. Again, best to virtual consult with

Mats Hagstrom, MD (license on probation) · Answer

There are a number of variables to take into consideration when assessing someone for the procedure and when assessing the outcome.
To start with your after picture, has you flexing your next slightly and this has a major impact on what the neck look like. before, and after pictures have to be taken with the head at the exact same angle!
Almost 100% of people seeking chin and neck liposuction have an underdeveloped mandible.
This is true for you as well.
You do have a chin that projects, but the body of the mandible is short and lacking in projection.
This shows you having a dental overbite occlusion.
On profile pictures, your upper lip has significant more forward projection than the lower lip and this is how I know you have an overbite occlusion.
 The problem is not distribution but related to the shape and size of your mandible.
We can’t really grow you a bigger mandible without involving very complex surgery so plastic surgeons try soft tissue manipulation to treat a problem which is inherently based on skeletal structure.
Next, delivering consistent quality, Liposuction results including the ability to make accurate assessments is more difficult than most people realize.The number of plastic surgeons who approach mastery of this procedure is in reality quite small.
Almost all plastic surgeons claim competency with Liposuction, but average Liposuction results really aren’t that great and the majority of plastic surgeons do average work.
Exceptional work is only done by exceptional providers.
Finding a really talented plastic surgeon is more difficult than most people realize.
Your pictures do show some improvement and if you extend your neck, the improvements will look even better.
Generally speaking secondary Liposuction delivers far less than the primary procedure.
Any liposuction procedure also has the ability to create permanent disfigurement.
 The more aggressive, the procedure is the more likely it is to leave permanent contour, irregularities, or disfigurement that cannot be corrected.
I bet if you extend your neck to the same angle, you show in your before picture the results probably look good and considering that fist distribution was never the problem in the first place. This may be the limit of what Liposuction can deliver.
We can’t really make an assessment regarding a procedure by looking at pictures.
We need to feel the thickness of the subcutaneous fat layer, feel the contour of the underlying platysma muscle and assess the degree of skin laxity.
We also need to know the patient’s age because With age patients lose the ability to have quality liposuction results.
Generally speaking, the best candidates for Liposuction are young, have tight skin and thick layers of subcutaneous fat.To get quality assessment, you will need in person consultations.
To help find the right provider I suggest patient’s schedule multiple consultations.
During each consultations, bring pictures of your face to use as reference.
During each consultation, ask each provider to open up their portfolioand show you their entire collection of before and after pictures of previous patients who had similar facial characteristics to your own.
Sufficiently experienced provider should’ve access to enough before, and after pictures that you don’t have time to look at all of them during the consultation.Highly experienced plastic surgeons should’ve access 100s or preferably thousands of before, and after pictures to choose from.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
Having only one consultation eliminates the ability to potentially choose a better provider.
Based on the pictures you’ve included, I think your procedure was done with competence.
In order to compare outcomes that neck angle has to be exactly the same.
Flexing the neck bunches of the skin and can creates a double chin even on people who have a defined jawline.
Most likely a secondary procedure isn’t going to deliver much more of a result.
Consider reposting with better pictures.
Again, make sure the neck angle is exactly the same.
Best,
Mats Hagstrom MD

Should I consider a second round of chin liposuction? 31 y/o female, unhappy with results (photos)

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