4 year old Facelift without Neck Lift - do I have the right to ask for the procedure I wanted? (photos)

I agree with your intuition! Neck liposuction is unlikely to provide the long-lasting result you are looking for. The fullness you see under your chin is probably subplatysmal fat (fat beneath the platysma muscle) which is not reliably or safely removed with liposuction. You need a deep plane neck lift to remove the deep fat and potentially contour the submandibular gland and digastric muscle in combination with platysmaplasty (muscle repair). You do not have extra skin so this operation can be done through a single incision under your chin. Thanks for your question and good luck!

Thank you for your questions and photos. When a patient is unhappy with a result it is best to initially return to the surgeon who did the case. Be open and honest about what your understanding was and what you arent happy with. If you aren't confident about the result of your follow up appointment, you can always get a second opinion by a board certified Plastic Surgeon. Based on your photos, your neck skin looks to be in very good condition. You have a small pocket of fat in the submandibular region under your chin. In our office we would liposuction the area and treat with a InMode facetite to tighten up any tissues that result from the lipo. This would all be done under local anesthesia right in our office. We also offer 3D imaging to give our patients an accurate idea of what their final result will look like. Good luck!