Uneven chin lipo 1 year post-op - how can I fix it? (photos)

Question

Chin lipo from one year ago is uneven and never improved. When I addressed this with surgeon she told me to lose weight. I'm more self contagious about before because it's very noticeable. What can be done to fix this?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Nima Shemirani, MD · Answer

Hi @goodandwell098. I'm sorry you are not happy with your final results.  It is best that you visit your plastic surgeon for further assessment and a treatment plan.

Best of luck,

Dr. Nima

Michael P. Morrissette, DDS, FACS · Answer

A touch up liposuction might be needed with release of the subcutaneous tissue. I would perform this with a small submental incision to release the skin. Simultaneously a small amount of skin can be removed.

Daniel Barrett, MD · Answer

Dear goodandwell098,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jeffrey Lisiecki, MD · Answer

You should be seen in person for this region to be examined. There are things to do to help smooth out the area, including revision liposuction, Morpheus8, possibly fat grafting depressions, but the key first step is being seen in person to examine the area and determine exactly why the irregularities are there, and after that a plan can be made on how to address them.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Unevenness after chin liposuction can be improved. I usually start with massaging the areas and using selective injections of steroid where fullness is present. After, I will initiate RF microneedling such as Morpheus8 to assist with improving the collagen and smoothing the skin. If those options don't work, you can add fat to the area in subtle amounts with the expectation of improvement. Or, you can consider a neck lift with undermining to "free" the uneven skin. Hope this helps you!

Darryl J. Blinski, MD · Answer

Based on your previous lipo chin history I might do re lipo indirected areas with firm compression and taping for 1 week before trying KyBella (fat dissolver) injections. Re surgery with new surgeon fee $4,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

When making an assessment on the outcome of a cosmetic operation we always have to see proper before and after pictures. If you don’t have those them please ask your surgeon to forward the ones they took. They are part of your medical record and you have a right to them.
Delivering consistent quality Liposuction results is more difficult than most people believe in this includes plastic surgeons. Plastic surgeons in general believe they are better at Liposuction than they actually are an average results are actually somewhat atrocious.
Mastering this procedure takes a total dedication and years of experience with a commitment to getting better and not just doing the same mediocre work again and again.
Liposuction results are more or less permanent and irreversible. Attempts at improvement are typically based on revision Liposuction(removing more fat to try to make it even) or fat grafting a.k.a. fat transfer.
In some situations converting the procedure to a skin tightening operation may be an option but not for you. an example of that would be poor Liposuction results on the lower abdomen and somebody who’s a good candidate for a tummy tuck in which case you simply cut out the area of concern and give the patient a tight flat abdomen with a tummy tuck.
To find the right provider for liposuction procedures I suggest patients start by having numerous in person consultations starting locally. During in person consultations ask each provider to show their entire collection of before and after pictures. Being shown a few sample pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. An experienced provider should have no difficulty showing you at least 50 sets of before and after pictures of chin and neck liposuction or any other commonly performed procedure. Ask the provider to open up their portfolio and show as many pictures as they have of patience with similar body characteristics or facial characteristics. You may want to ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. The only reason a provider can’t show you a large collection of quality pictures is because they don’t have them. When that happens you simply go to the next consultation.
Chin and neck liposuction can be done using general anesthesia, local anesthesia with sedation or local anesthesia alone. Most of the time I use local anesthesia with light sedation. This can easily be done in an office setting especially if it’s a small revision.
in your case did your provider show you example before and after pictures? If she did you can go back and have her pull out the same pictures and then compare with your own pointing out that your results are substandard to what she had conveyed that she could deliver. 
Getting a less than awesome Liposuction result it’s not malpractice but it did leave you disappointed and it doesn’t hurt to negotiate to see if you can get some of your money back. Weight loss does not change fat distribution and you can tell your plastic surgeon I said so.
She may or may not be open to giving you a refund bed approaching this in a professional and an non-emotional business like manner may be worth a try.
Threatening to write bad reviews is not the right approach but it is appropriate to write an honest, accurate and professional review about your experience. Sharing with your provider that you engage on social media and have lots of friends who are interested in having procedures may drop a hint.
In regards to getting an improved outcome I will tell you that revision work is many times more difficult than primary Liposuction. results can easily be made worse by an attempt at revision especially if any part of the Area was over treated.
Considering the outcome I don’t think your provider is your best choice in regards to who should do the revision work.
Like I mentioned revisions are many times more difficult than primary Liposuction so the importance of choosing the right provider becomes paramount.
When it comes to Revision Work you’re not gonna find plastic surgeons that have as many before and after pictures but typically those who are good at the primary procedure tend to also be good at revision work. The only exception is if you need fat transfer. not all plastic surgeons have experience doing that. Fat transfer to correct previous liposuction is very difficult and often the fat does not survive well. For that reason if grafting fat is needed it may require several procedures.
The key is always defined the most talented and experienced provider.
Finally I recommend reading all reviews and various physician review websites avoiding providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
There are no non-surgical options they can help your situation.
Best,
Mats Hagstrom MD

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