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I Am 6 Months Post Op from a SMAS/Platysmaplasty - My Jawline is Firm Except for a Spot Where Some Sutures Broke After an Exam?

I dont' think I have many options as my neck is thin and there are already irregularities that I will need to address. I am thinking of doing a submandibular lift as I don't mind an external scar on my neck and I don't want to redo the entire neck lifte because of this spot. I've also heard the "Exilist" has a device that tightenes skin only. Again, I have absolutely no fat in my neck (actually devoid of fat). Would Exilist work for this area or is this more hype just like Thermage?

Doctor Answers (4)

Suture Broke and Revision Neck Lift

+1

   This one is difficult to answer as one is not sure what the suture broken was holding.  If this was a lateral plication suture holding the platysma and there is midline platysmal laxity, a platysmaplasty may address this.  If there is a skin excess in the midline neck some of the neck skin can be removed through that incision.  Hard to say.  Kenneth Hughes, MD facelift Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 220 reviews

SMAS revision

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Without an exam, it is difficult to say what might be able to be done for you. Best to be seen a surgeon in consultation.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Skin Tightening after Face lift or Neck lift

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Without photos or an exam I cannot answer your question specifically. However here is some general information that might help: Thermage and Ulthera use radio-frequency to heat the skin and deeper elements causing it to tighten. Lasers and Peels are more resurfacing procedures that cause tightening and microscopic dermal thickening. My experiences is that all of these have limited applications and that is why when you look on RealSelf satisfaction ratings they are rated relatively low.

Best advise: see a Plastic Surgeon, Facial Plastic Surgeon and ask for their opinion.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 47 reviews

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Further Skin Tightening After a Facelift

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Your question is actually one that many people ask after a facelift, namely what other technologies can be used to achieve further tightening, be it for mainteance or for correction of one spot where you are experiencing laxity/irregularity.

 

There has been an explosion of devices over the past several years that can help tighten the skin on the neck and jawline non-surgically. Many of these devices work very well in the post-facelift setting. Some devices like Thermage and Ulthera are singular treatments that can be done at longer intervals (1 year minimum), while others require more treatments and maintanance ( Apollo, Viora, Pelleve, Excilis, EndyMed, etc). Furthermore, the devices that require fewer intervals tend to be associated with some pain (and need for numbing), whereas some of the newer devices progressively warm skin and hold temperatures for periods of time and are generally considered pain free. For the health consumer, the ability to decipher between technologies can be dificult, and practices may not always be helpful in giving you comparative experiences.

 

To this end, I feel it is important that practices that employ these devices be able to demonstrate some examples of their outcomes in facelifted patients and this have experience in using the device to treat this subset of patients. Your questions along these lines will give you confidence as clinicians explain their experience using their device on facelifted patients. Furthermore, high volume facelift practices usually have experience with several of these devices, and will be able to give you some context to their recomedation. The good thing here is that if one device does not work for you, they can switch you to another device and try a different protocol.

 

Finally, some facelifted patients may not achieve the best results with these devices, seocndary to issues like scarring or fat volume assymetries that these devices are not meant to handle. To this end, Smart Lifting (Smart Lipo) is a great tool for facelift touch ups to address concerns like the one you mention. Hope this helps.

Farhan Taghizadeh, MD
Albuquerque Facial Plastic Surgeon
4.5 out of 5 stars 13 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.