Asymmetrical chin 1 year after facelift + liposuction. What can I do? (photo)

Question

I had a facelift over a year ago. It was asymmetrical, so lipo was done to remove the fat left. Sadly, this left a dent in my face and so a minor revision was done with a fat graft to fill the dent . It still looks so asymmetrical with obvious hollowing. What can i do apart from surgery? After all thats happened, i would like to avoid any additional surgery Thank you

Semih Yildiz, MD, FEPOBRAS · Answer

At more than a year out, persistent contour asymmetry is usually less about normal swelling and more about a structural issue such as uneven fat removal, scar tethering, fat graft survival, skin adherence, or pre-existing facial asymmetry becoming more visible. I reviewed the photos; they show lower-face/chin asymmetry with a hollowed area along the lower cheek/jawline region, although the exact cause cannot be confirmed without feeling the tissue and checking movement.

If you want to avoid more surgery, the most practical options are conservative camouflage treatments rather than a true reset. A very cautious hyaluronic acid filler trial can sometimes soften a hollow and is adjustable or reversible, which is useful in a revision setting. If the skin is tethered, some doctors combine small-volume filler with subcision or other scar-release techniques, but that still requires an in-person assessment and should be done slowly. If the asymmetry changes when smiling, a small amount of neuromodulator may help muscle pull, but it will not replace missing volume. I would return to your operating surgeon for records and also consider a second opinion with a facelift revision specialist before adding anything, because overfilling a post-liposuction hollow can make the contour look heavier or less natural.

Zeshaan Maan, MD · Answer

If you’re not interested in facial fat grafting (which would likely be the best solution), then the use of hyaluronic acid fillers for facial rebalancing is likely your best option. I highly recommend you have a consultation with a board certified plastic surgeon to be assessed and determine the best path forward.

Zoran Potparic, MD · Answer

Small asymmetries after face lift surgery may be result of fat necrosis or displacement. Correction with fat graft is most logical step but may not always result in complete correction. Repeat of fat grafting or use of HA tissue filler are the options. Hope this helps.

Kamol Pansritum, MD · Answer

I understand your concerns about avoiding more surgery. However, if asymmetry and hollowing persist, non-surgical treatments may offer only minimal improvement. A revision facelift combined with an upper lip lift (to correct a long upper lip) and possibly a lip corner lift may provide a more balanced result.

Sean Fisher, MD · Answer

without doing an examination it is difficult to fully assess the cause of this. It could be due to asymmetry fat removal, asymmetric treatment of the deeper structures of the face and neck, or issues with skin re-draping post-operatively. In order to provide the best course of action, a full exam would be needed. Some targeted liposuction may improve things to a degree, but if this has already bee unsuccessful a full revision is likely the only way to correct this issue. 
Sean Fisher MD Aesthetic Plastic SurgeonSeattle, WA

Asymmetrical chin 1 year after facelift + liposuction. What can I do? (photo)

Answers (5)

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