Lower Facelift and Platysmaplasty 8 Weeks Ago and I Still Have Lump Under my Chin

Is this normal or do I need liposuction? Prior to surgery my PS didn't think it was necessary and I didn't either(I am slender w/ good skin elasticity). When I saw him last we discussed the neck bands still present and the lump. He said that he should have done liposuction. I am not so sure although the neck bands are still there. I just think this may be a seperate issue and I don't want to have any extra unnecessary surgery. I am reading that these lumps are not so uncommon. Thank you

Doctor Answers 8

Facelift with Platysmaplasty

The lump under your chin can be caused by a number of things.  First, being you are only 8 weeks out the fullness under the chin may represent a fluid collection, a hematoma(collection of blood), or generalized inflammation or induration.  Fortunately, when recognized and addressed each of the above situations can resolve over time with proper minimally invasive managment.  Other reasons for fullness under the chin can be lack of fat removal when treating the neck or possibly bunching of the platysma muscle after midline platysmaplasty (although you stay  the neck bands are still present).  These are situations which will require a revisional procedure in the future.  Good Luck.....Dr. Corrado


Philadelphia Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Lump under the chin in 8 weeks after a facelift

At only 8 weeks after the facelift, small lumps and irregularities are normal in the neck area. It is impossible to determine at this point whether its temporary or permanent. Its best to use ultrasound therapy, low salt diet,  or cortisone shots to help make the lump subside. If it is still present after 6 months and  it is fat, a small amount of liposuction may resolve the issue. If it is a muscle issue, then  a revision platysma plasty may be required. For many examples, please see the link below  to our facelift photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews

8 Weeks After Platysmaplasty

Although it is totally normal to have some degree of swelling 8 weeks after a Facelift, the residual presence of neck bands is not.  These findings can only be evaluated by your Surgeon and should be examined.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 48 reviews

Swelling under chin after lower face lift

Dear Lower Facelift Patient from New Jersey,
According to your description, you might have bunching of platysma band and skin, fluid collection, or generalized edema (swelling). Eight weeks post lower face lift is too soon to judge the long term outcomes. Talk to your Surgeon, or you can get a second opinion in two months if the issue persists. Good luck and good healing
 

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 111 reviews

Lump in neck

A lump under your chin after platysmaplasty may be the bunching of the plastysma or could be fat or could be fluid. It is hard to say without an exam.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

It depends on a couple of things, the type of platysmaplasty and whether or not you had a hematoma afterwards

Hi Nicole1031,

Good question, but it really needs more clarification in order to say whether or not this it normal after surgery or whether you need more surgery.

First, a platysmaplasty can also be a lateral platysmaplasty, where the surgeon doesn't operate on the muscle bands from the area under the chin.  If a "real platysmaplasty" AKA corset platysmaplasty or midline platysmaplasty was performed, then usually there is an incision at least 3/4" to 1 1/2" in the horizontal wrinkle under the chin.  Since no liposuction was performed under the chin, if you don't have any incision under the chin, then you didn't have a mid-line or corset platysmaplasty.

The lateral platysmaplasty, is when the surgeon lifts the platysma muscle from the sides, or "laterally."  In my experience, I could not smooth out the muscle bands enough lifting from the sides.  I find that tying the muscle bands from their separation along the middle of the neck to be much more effective.

If you do have an incision under the chin as described, then you probably did have a midline or corset platysmaplasty by your surgeon.  If this is the case, it is not uncommon to have a small blood clot or hematoma after these procedures, which appears to be a "lump" under the chin, and is not actually fat.  If this is the case, then it will likely flatten out as your body absorbs the blood clot over the months.

If a midline or corset platysmaplasty was performed, usually the surgeon can tell while operating in this area if liposuction or direct shaving of the fat needs to be performed in addition to the platysmaplasty.

In your case, it is impossible for me to say what happened to you, so you will need to depend on your own surgeon's evaluation since he or she has had the opportunity to see and examine you as well as operate on you.  Only this surgeon really knows you "inside" and "out."

Since we are hoping that you don't need any additional surgery, I'm rooting for it being simply a small residual hematoma, which just needs time to absorb.  This should flatten out without any additional surgery, especially since you said you have good skin elasticity.

Best,

Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Face and neck lift

After face and neck lift it not uncommon to have lumpiness nd eneveness because of swellingand the healing process.

it all depends on what was done to the neck.

Even though you are slim you still could have excess fat under the muscle that causes full neck.

the bands are the platysma muscle seperated and causing bands which is repaired by Platysmaplasty and that involves suturing the edges of the muscle in the midline and weakining of the muscle.

Consult a BOARD CERTIFIED PLASTIC SURGEON ( AMERICAN BOARD OF PLASTIC SURGERY) for advise.

Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.