After 2 neurologists, an MRI, CT & ultrasound it appears that I have a compression neuropathy (due to adhesions/scar tissue growth) post neck lift surgery. The plastic surgeon that performed the surgery is not forthcoming. I have a noose-like sensation that started only in the platysmal area on the rt side and is creeping to left. My surgeon insists he did not use permanent or suspension sutures. I am an MD and am appalled at the lack of help. Any advise as the discomfort is now unbearable.
Scar Tissue/adhesion Formation After Neck Lift?
Doctor Answers 4
Feeling of Extreme Tightness after Neck Lift
You are not an isolated case of this syndrome. I have seen a number over 30 years and continue to see and correct those that feel too tight. Generally the history gos something like this. A normal patient and good candidate has a neck lift and 5% end up feeling too thigh . This can occur in the cheek, forehead, or neck area. The major complaints occur in the neck. I have had 3 patients like this in my career and have seen another 9 that I can recall coming by referral. The complaints are all similar. TIGHTNESS. What to do? Initially we tell people it gos away but sometimes it does not. What to do? Certainly serial Kenalog injections in the mastoid area bilaterally if needed and dilute Kenalog at selected points along the neck almost always help. These can be repeated in 6 weeks. In cases where I know the surgeon well and know that a very tight SMAS and platysma were done, I re operate and loosen everything up. The results have been 100% successful on 7 patients. Sometimes things don't seem tight but they feel tight to the patient. Go in and loosen up everything. At the end of the surgery spray dilute Kenalog over the entire wound surface. 100% successful. The main villains were very tight SMAS and Platysmal suspensions. It is easy to take this down. Even if this does not feel tight, it is, and loosening it always corrects the problem. Certainly permanent suspension sutures can also be the enemy but no patients I saw had this. The suspensions like that of Giampapa work for some but could be a cause of the tight feeling. So the answer is time possibly, triamcinolone possible, and operative intervention which seems to always work even when it seems that it should and would not work. We must listen to our patients for sure.....even when they are MDs. MDs are simply patients that must be cared for like all others. Mu Best, Dr C
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Neuropathy after a neck lift?
As an MD yourself, you should have a better understanding of that pathophysiology of such problems. Which nerve is suspected of being injured? And what are your symptoms? We all know where the nerves are and if there is no suturing done around the nerve, how can there be a compression neuropathy? There are always other possibilities.