To make a Quality assessment regarding the outcome of any plastic surgery procedure we need quality information.That generally means getting access to a complete set of proper before and after pictures.If you don’t have your before, and after pictures and ask your surgeon to forward the pictures they took.Liposuction results are based on two variables.The first disc of candidacy of the patient and the second is the skill of the provider.A sufficiently talented provider should be able to assess the candidacy of each patient and understand what results will look like and communicate this clearly during the consultation. Not everybody seeking Liposuction it’s a good candidate or has the potential of having high-quality outcomes from this procedure.Individuals who are good candidates for Liposuction are typically young, have tight skin and thick layers of subcutaneous fat.The opposite is also true. Individuals who are older(causes loss of skin elasticity), have skin laxity and have thin layers of fat do not have the potential of getting good results regardless of who does the procedure. From the single picture shown it looks like your provider was a bit aggressive removing “a lot” of fat. Probably hoping to get “a better” result. If he had sufficient experience he may have recognized that side effect or drawback to being shredding in a patient who did not have the skin elasticity to tolerate that level of treatment without having some skin compromise. Delivering consistent quality Liposuction results is in reality more difficult than most people realize.The number of plastic surgeons approach mastery of this procedure is also quite low.Most plastic surgeons think they are better at liposuction than they actually are. In your case a neck lift may have been a better procedure in the first place. The missing fat layer is now still going to be there even if you get a neck lift. Improving your outcome is not going to be easy. There is a procedure called a cervicoplasty. It’s the medical term for a neck lift but sometimes implies a different approach where the skin excess is removed from under the chin as opposed to around the ears. At this point I suggest you slow down the train and get a number of second opinion consultations before having more surgery. I recommend you avoid virtual consultations and schedule exclusively in person consultations.Look for plastic surgeons in your area that focus on facelift surgery or have a lot of experience with facelift and neck lift procedures. For second opinion, consultations always come prepared bringing with you a complete set of proper before and after pictures and copies of your previous operative report.You can get these from your current providers office if you request them.They are part of your medical record.The more consultations you schedule the more likely you are to find the better provider for your needs.Any attempt at revision surgery can always make things worse.During each in person consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients with similar facial characteristics to your own for whatever procedure you are contemplating.Take care notes during the consultation, especially regarding the quantity and quality of before, and after pictures shown.Being shown only a handful of pre-selected images representing only the best results of a providers career or of patients whose candidacy for the procedure was different than your own may be insufficient to get a clear understanding of what average results look like in the hands of each provider. This may also be insufficient to get an understanding of what your results will look like or how many of these procedures they have done. Highly experienced plastic surgeons should have access 100 or preferably thousands of before and after pictures to choose from.There’s no correct Number of consultations needed to find the right provider.The biggest mistake I see patients make is having only one consultation which more or less eliminates the ability to choose a better provider.a cervico plastic may be advantageous because it would help remove the skin that no longer has a sufficient layer of subcutaneous fat. That said a cervicoplasty has certain other drawbacks and your previous liposuction will make delivering a quality neck lift outcome challenging. I encourage anyone considering having Liposuction to be more selective regarding provider choice than you may think is necessary.I generally recommend people have at least 3 to 5 consultations before selecting a provider.Always insist on seeing as many before and after pictures as possible previous patient who had similar candidacy for the procedure as your own.This means seeing the results of previous patients who were of similar age, same degree of subcutaneous fat, same skin laxity and similar bone structure. The biggest mistake I see patients make it having only one consultation, then scheduling surgery.The second biggest mistake I see patients make, is assuming that someone who’s board-certified in plastic surgery with a few years of experience and a handful of positive reviews has mastered most plastic surgical procedures.Most plastic surgeons deliver average work.Only exceptional plastic surgeons, deliver exceptional outcomes.The number of plastic surgeons who approach master of Liposuction is in reality quite small.I would say less than 5% of plastic surgeons are “good at liposuction”.Best,Mats Hagström MD
