Avoiding regret with liposuction lift: distinguishing the signs to prevent irregularities and residual sagging

Common regrets after liposuction lift are irregularities from removing too much or too little fat, and skin sagging (skin laxity) that remains after fat reduction. Both become more likely depending on whether the amount of fat and skin laxity are assessed separately. Research examining the combined procedure itself is not readily available, so we organize the findings from individual reports.

What is the most common failure?

The most common complications of liposuction—residual fat, over-removal, and surface irregularities—are summarized in textbooks[1]. Over-removed areas appear as depressions, and residual fat appears as bulges.

Over-removal and under-removal are opposite failures. It is important to align on the approach to how much fat to remove with your surgeon beforehand.

When skin sagging remains after fat removal, what kind of patient is this?

Patients with strong skin laxity. Under-chin liposuction is effective for younger people with abundant fat but minimal excess skin, but problems are more likely to occur in older patients with significant excess skin, according to textbooks[2]. In such cases, a Facelift may be necessary[2].

Some reports suggest that Thread lift can address skin sagging that appears deflated and lacks firmness after liposuction[3]. However, this is not a study that confirmed the combined effect with numerical data.

What additional risks come with adding threads?

Thread lift-specific changes are added. In a review of multiple studies, the most common complications in order are swelling, skin depressions, numbness, visible/palpable threads, infection, and thread extrusion[4]. Non-absorbable threads and older age were associated with higher rates of complications[4].

Cheek skin depressions become more likely if threads are pulled too tightly or placed in the wrong position[5]. The rate of thread extrusion through the skin is reported as 1.6% for absorbable threads and 7.6% for non-absorbable threads[6].

How common are nerve and scar complications?

In a review of under-chin liposuction, nerve injury was rare, and temporary facial nerve paralysis occurred in only one study[7]. On the other hand, there were 2 cases where scars restricted movement and required surgical revision[7].

Infection after facial procedures can develop weeks to months later[7]. Thread lift can rarely damage the parotid gland (salivary tissue) or facial nerves, resulting in swelling or asymmetry of facial expression[5]. It is reassuring to confirm beforehand whether you can be seen promptly if any concerning changes develop.

Is there a possibility of having other surgery in the future?

If so, you should mention it initially. Threads placed recently increase the risk when undergoing later procedures such as Facelift, according to expert recommendations[6].

If you are considering future skin tightening surgery, consulting about thread type and timing at the outset will help keep your options open.

What to assess before treatment

There are three benchmarks for judgment. The first is whether the jawline fullness is caused by fat or skin laxity[2]. The second is the plan for how much fat to remove[1]. The third is the thread type and number, and what happens if threads extrude[6][4].

Whether fat or skin laxity is the primary cause cannot be determined from photos or articles alone. Please confirm with your surgeon at the consultation what can be tightened in your own face.