Too Much Fat Removed After Chin Lipo

Question

I had sub-mental liposuction a year ago, and the doctor took out too much fat in the area at the base (where neck meets jaw) and there is a triangle area which is depressed and was hard to photograph, basically it looks like a hole as if someone's thumb is pressing up and people have commented on it, also now my glands are more visible. Could a fat transfer fix this? It's just the one area. Should the surgeon who did it try to fix it? Price estimate for area? I can't believe it happened!

James F. Boynton, MD, FACS · Answer

Liposuction of the neck is often a subtle thing and too much fat can surely be removed in the central area of the neck which can lead to contour deformities or irregularities.   It is difficult to see this area you describe in the picture because of the angle of the photograph, but from your description is sounds like you may have a contour depression in the central neck.  My recommendation is to go to a board certified plastic surgeon with experience with corrective secondary liposuction (revision liposuction).  I routinely perform corrective or secondary liposuction procedures but not everyone does, so ask your surgeon for their honest recommendation.

	Basically you would likely need a revision liposuction of the neck with small cannulas, also using a special cannula to "free up" the skin and any scar tissue and possibly using some fat injections to "fill" in any contour defect. You are also very right in your description that when too much fat is removed, the "glands" (submandibular glands) become more visible. I see this kind of problem more commonly when patients have had "laser" liposuction in the neck, but the treatment is the same.  Sometimes fat injections have to be done more than once, but usually a nice correction can be achieved in the right hands.  I hope this helps!

	Sincerely,
	 

	James F. Boynton, M.D., F.A.C.S.

Richard J. Bruneteau, MD · Answer

Contour irregularities can
occasionally occur following liposuction of the neck.  The vast majority of these cases respond to compression and
massage, but in some cases these changes are permanent.  When this happens, these deformities
can be treated in most cases with fat grafting.

When this situation arises, it’s
important to consult your original plastic surgeon.  Under these circumstances, many surgeons will discount
revisional surgery.  Significant
improvement can occur with fat grafting and the procedure is associated with
high satisfaction rates.

Vivek Bansal, MD · Answer

On the neck from &ldquo;just right&rdquo; to &ldquo;too much&rdquo; is a very thin line.  First, we recommend seeing a Board Certified Plastic Surgeon for this.  Over 95% of the complications we see are from non Board Certified Plastic Surgeon offices.  A fat transfer may work, but an evaluation is needed.

Harold J. Kaplan, MD · Answer

I disagree with many of the answers already given regarding your problem. Over-aggressive liposuction in this area usually also causes significant scar tissue, which makes fat grafting later as a correction difficult to resolve the problem. Most of the time, submental muscle repair to smooth and flatten the depressed area is required.

Arturo Guiloff, MD · Answer

It's hard to evaluate the area of concern in the picture. Many times a combination of delicate miniliposuction combined with fat grafting can correct those localized abnormalities. I would definitely talk to your original surgeon first.

Ron Shelton, MD · Answer

If more fat was taken away in one area than others, the indentation after liposuction may be improved by a fat transfer / fat injection. There may be considerable bruising for more than a week or two because of further manipulation in an area that had undergone surgery previously.

Anthony Corrado, DO · Answer

Many times overaggressive liposuction can lead to contour irregularities which is what you are describing. Free fat transfer is an excellent means to fill the "voids" from your prior procedure and allow for smoother contours in the neck. Good Luck....Dr. Corrado

William Bruno, MD · Answer

If you have an irregular contour with indentations or divots after liposuction, you can have the area filled in with a fat transfer.  This involves harvesting fat from one area (ex. abodmen) and transferring it into the area of concern (in your case, the neck).  Not all of the fat will survive, so you may need a second procedure for a touch up. 

	Consult with a board certified plastic surgeon for a complete examination and review of your surgical options.

	Best wishes,

	Dr.Bruno

Pedy Ganchi, MD · Answer

Hello,

	       Fat grafting is ideal in correcting this problem as it can help soften the irregularities.  It too requires experience and can be unpredictable, but is likely your best option.  Consulting with your own surgeon is good practice.

	Dr. Pedy Ganchi

	Village Plastic Surgery-Ridgewood, NJ

David Shafer, MD, FACS · Answer

It is hard to tell from your photo the extent of your issue.  However, fat grafting is likely the best option.  Another option may be serial Sculptra injections.  Your best bet would be to go back to your original surgeon.  Price vary widely from city to city and doctor to doctor, but you are probably looking at sub $5K range for this procedure.

	 

	Good Luck.

Amy T. Bandy, DO, FACS · Answer

Contour irregularities is a known risk with liposuction.  If you surgeon is experienced in fat transfer, that would be your best  bet, and likely the most cost effective for you. Good luck!