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What Can Be Done to Repair my Neck/facelift? (photo)

I'm 72. In June, 2012, I had a neck & lower face lift & liposuction on neck. After, there was a lumpy area under my chin. My doctor said to wait nine months. My lips were stretched , but within two weeks, that had improved. However, it's continued to come undone - my jowls, lines from nose and mouth, neck wrinkles are reappearing (about 50% undone) and under chin is much worse. Two PS said I had good skin elasticity. What can be done? An in-office procedure? Should I trust the same doctor? Help!

Doctor Answers (23)

Revision Neck / Facelift Procedures

It is difficult to truly assess what is happening, but it appears like the skin under the chin (submental region) has become attached to the underlying muscle, and as the surrounding facial skin droops it is causing that lumpy appearance.  You likely will benefit from some type of revision procedure, in which the skin and perhaps underlying deeper tissue is returned to a more desirable aesthetic position.  One question - prior to  your surgery, did you have any significant weight loss?

Miami Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

This needs revision


Opening the original facelift incisions and submental incision and redraping the skin is the only way forward here.

Good luck!

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Elasticity and skin quality skin need to be determined by physical examination before a revision strategy


There appears to be a regression and collection of extra skin below your jawline and you clearly need some revision in order for you to look good. This phenomenon depends a lot on factors such as skin elasticity. Unfortunately, we can’t do a proper assessment with only the photos you have sent. It’s important to have a physical exam to make decisions about the level of surgery and the extensiveness of the procedure. When I do an examination, I lift the skin and look at how much lifting needs to be done and where the incisions have to be placed.

In my practice, I do all my facelifts and neck lifts under local anesthesia with sedation. That means getting an IV, some liquid valium and propofol, and then the patient can be relaxed throughout the procedure. We have our own facility, so technically it is an in-office procedure.

I suggest that whenever people consider revision surgery with a procedure like face lifting, it’s your first doctor who should be doing the revision or enhancement of the surgery. It’s because they are already familiar with the elasticity and the quality of the skin, and most of all they know what to expect with your surgery. If all those things feel right with you and then you can go ahead and proceed. I hope that was helpful, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 27 reviews

Secondary Neck and Face lifting


The advice you have already received seems on the mark. The only thing I can add is that you should be careful not to fall in the minimal surgery conundrum. This means do not listen to anyone who thinks this can repaired by anterior undermining and a submental incision. Your bands may or may not be platysmal and actually look like skin bands to me. A complete undermining with special care to tighten, drastically, the neck skin with both pressure bandages and drains probably necessary for smoothness of the redraped skin and to make sure no fluid collections mar the early result. For a young 72 you have had enough go wrong so choose your  real Board Certified Plastic Surgeon carefully.

Paul S. Howard, MD
Birmingham Plastic Surgeon
5.0 out of 5 stars 7 reviews

Corrective Face/Neck Lifting



This is a good question – and I am sorry that you have to ask it.  Any irregularities after facelift and neck surgery should be resolved by your stage of healing. What is most important, with relation to your question, is that you can have a markedly improved result. This would require an additional surgical procedure, in an operating room, to correct residual skin left behind and the asymmetry of the neck fat removal.

Be healthy and be well,

James M. Ridgway, MD

James M. Ridgway, MD, FACS
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Facelift result


Based on your photo, you have contracting scrs in the neck and prominence of your muscle bands. In my past, you can release the scar and tighten the muscle for improvement. discuss this with your surgeon. All the best

Thomas A. Narsete, MD
Greenwood Village Plastic Surgeon

Neck lift revision can be effective way to improve neck contour


You appear to have adhesion of scar with surrounding neck skin laxity. I imagine that your neck was relatively heavy and lax prior to surgery. I would advocate for revision of face and neck lift to release submental scar and redrape the skin excess that you have. This can be fixed, but its going to require an operation.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 36 reviews

Revision Facelift and Necklift is needed


Dear Polishmama, You will need a full revision facelift and neck lift similar to the original surgery. You need to have these  areas undermined and the skin needs to be resuspended to smooth out this area under the chin and neck. I would suggest a second opinion as well as discussing your concerns with your previous treating physician. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 130 reviews

Excess skin after a facelift will require formal revision.


The neck generally does quite well after a facelift. This requires however adequate mobilization of the skin, advancement, and removal. The contour problems of your neck will require another operation. They are correctable.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Facelift Revision is another Facelift


Now that you have reached the point of maximal rebound skin relaxation, you can consider a facelift revision for improvement. That revision would essentially consist of a near repeat of the original facelift proceure as all the skin flaps must be remobilized and resuspended to smooth out all of these problem areas.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 27 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.