Is skin tethering permanent after chin lipo? (Photos)

Question

I had chin liposuction a year ago, and a few months into the healing process, I noticed that the results seemed uneven. There is a small pocket of fat left on the left side, and I also observed skin tethering on both sides, with the left side being more prominent. When I talk or laugh, that pocket of fat becomes more noticeable due to the way the skin is pulled. What can I do to improve this? Is there a way to address it without surgery? I'm afraid of undergoing another procedure and potentially getting worse results.

Eric M. Joseph, MD · Answer

Some people can develop uneven skin under the neck after neck liposuction. Orpheus 8 treatments may be performed with topical anesthetic, and they may help improve skin irregularities. Although they can melt some residual fat, if there is persistent fat, sometimes a small revision procedure is the best way to remove it. I hope this helps, and thank you for this question. Sincerely, Dr Joseph

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your question and for sharing your photos—what you're describing is a fairly common concern after chin liposuction, and your hesitation about another procedure is completely valid.

What Could Be Happening:
That small bulge on the left side may be residual fat, but it could also represent part of your submandibular gland, which sometimes becomes more visible after fat removal. The skin tethering you’re feeling—especially when talking or laughing—could be due to contracture or scarring in areas where very little fat remains, creating those visible contour irregularities.

Non-Surgical Options:
If you have true skin laxity, there are non-invasive treatments that may offer some improvement:

Radiofrequency (RF) skin tightening
Ultrasound-based treatments like Ultherapy
RF Microneedling
However, these are only effective if loose skin is present. If your skin is already tight and the issue is volume-related or structural, these treatments won’t address the deeper problem.

Surgical Options to Consider:
Fat Grafting
A small amount of fat can be transferred from another area to smooth out indentations and balance the contour. This is a good option if there’s too much volume loss or tethering.
Submandibular Gland Evaluation
If the bulge is gland-related rather than fat, a skilled evaluation is crucial. In rare cases, a submandibular gland reduction can be considered, but it carries higher risk and should only be done by a surgeon experienced with neck anatomy.

A thorough, in-person assessment with a board-certified plastic surgeon will help confirm the source of the issue and guide the best treatment plan—whether surgical or not. You're asking the right questions, and with careful planning, improvement is absolutely possible.

All the best,
Earl Stephenson, Jr., MD, DDS, MBA
ESJ Aesthetics

Anna Chacon, MD, FAAD · Answer

Skin tethering and uneven results after chin liposuction can be concerning, but there are non-surgical options that might help improve the appearance. Here are some suggestions:

Massage and Manual Manipulation: Gentle massage of the affected area can sometimes help in breaking down scar tissue and improving skin elasticity. A professional lymphatic drainage massage might also be beneficial.

Radiofrequency or Ultrasound Therapy: Treatments such as Thermage or Ultherapy use heat to stimulate collagen production, which can help tighten the skin and potentially reduce the appearance of tethering.

Laser Treatments: Non-ablative laser treatments can improve skin texture and stimulate collagen, which might help in evening out skin irregularities.

Microneedling: This procedure can improve skin texture and promote collagen production, which may help reduce the appearance of tethering over time.

Dermal Fillers: In some cases, strategic use of fillers can help to even out irregularities by adding volume to areas where fat may be lacking.

Topical Treatments: Regular use of topical retinoids or other collagen-boosting creams can help improve skin texture gradually.

It’s important to consult with a board-certified dermatologist or plastic surgeon who specializes in post-liposuction care. They can assess your specific situation and recommend the most appropriate non-invasive treatments tailored to your needs. Additionally, they can provide reassurance and guidance to help you achieve your desired results without the need for further surgery.

William Portuese, MD · Answer

Liposuction can only accomplish removal of fat deposits above the muscle, and you still appear to have significant fat deposits located below the platysma muscle in your neck, in addition to fat deposits also located above the muscle. Consider a neck lift procedure to remove both compartments of fat surgically with a platysma plasty to significantly improve your jawline.

Is skin tethering permanent after chin lipo? (Photos)

Answers (4)

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