Lumps on Side of Face After Neck and Cheek Lift.

anonymous57 16 Mar 2012

I am an independent cosemetic consultant with no affiliation to any ps. I have also had a FL and can relate to a lot of comments here. Doing your research is so
Important as is having realistic expectations. Having said this you still maybe unhappy with your results. As I am. There is a fine line between natural and not tight enough. Be sure to discuss this with you ps surgeon,
I do private confidential consults, and follow- up coaching to help make your post-op journey more pleasant. You can contact me info@ niptuckcoach.com or go to my website.

NHaven 16 Mar 2012

Dear Nieve, The fat injected from my tummy into my face basically didn't last. I'm 15 months from my face lift "revision" and have jowls, ridges, numbness, neckbands and everything else. My neck and sides of my face are still sore. The ridges along the side of the face are from the O-type suture used in a MACs lift. That's why they run in a line. Because the suture is done in a line. I have that, too. As time passes the skin stretches and the injected fat thins so the ridges aren't as noticeable. One RealSelf doctor said it's possible to remove the sutures but I don't know if that means the tissue will fall. I also have lumps in front of my jowls which my ps said was "tissue healing" but another ps consult said it was fat infection that hardened to a marble. After 8 months I applied high frequency vibration because I couldn't stand it anymore, and it actually helped a lot. I also had the corset platysmaplasty because my ps only did the under chin neck tightening and didn't remove any skin into the neckline the first time and I looked like someone took an ice-cream scoop under my chin. It was soooo painful I had to wear my chin strap every night for 4 months and get worthless botox injections in my neck for $500 more! The problem with the extended platysmal work (sewing the band together at the midline) got that in my redo--- is that the turkey waddle is replaced by a fibrous band (under the skin) from the chin to the adam's apple. My ps consult said he stopped doing that procedure because he had trouble controlling that banding, also. The descending or visible submandibular glands are very, very common. It makes sense since everything descends with age and our loose and fatty necks normally cover it up. This surprised me more than anything else because I had never heard of it and surgery to suspend or remove the glands is too risky. I don't know the solution. Injecting fat into the face with skill and moderation doesn't last completely, maybe a little bit does. But I looked like a cabbage patch doll, lumpy and fat faced for a year. Consider that when you decide. I would love for a ps to give the honest and total truth but, maybe, you have to actually have the face lift done to understand. I'm angry at my ps, also. I'm going for a second eye surgery repair with another doc for damage he caused with the bleph he did. At this point I just want to forgive my original ps and get over the anger. I wouldn't let him touch me again. Have learned the questions to ask through RealSelf. Know to look for results in patients 1+ year out and not 6 weeks! Run away fast if asked to sign a non-disclosure agreement. Someone who misrepresents their skill once will do it again....Best wishes to you. Keep us posted!

e1948 16 Mar 2012

Dear Nieve, I feel so bad for you. I'm glad you're going to another PS for advice. My PS suggested taking fat from my tummy and injecting it into my face also. Last Spring he injected filler into my cheeks and it helped a little but not that much. I'm not going to have the fat injected (though I'd love to have some removed from my tummy LOL) because he said if I gained any weight it would go directly to the fat in my face. Thats all I need. LOL. You just hang in there honey, I'm sure you're just beautiful and a face lift is MAJOR surgery and heeling takes time. I wish you all the best! BTW I'm the only one to notice any flaws in my face and I'm sure you are too. Take care.

Neive 16 Mar 2012

Reading your posts and more dismayed than ever. I am now six weeks after surgery (minilift and neck lip) have had a a check with my PS three weeks ago. The skin under my chin is like a turkey, but wobbly and tight st the same time. SP told me I had some type of thrombosis in the tendon and to go home and massage it and return in 3 weeks which will be the 27th of this month.

I cannot begin to explain the pain when I try to massage it and in the morning under the chin is so tight I cannot lift up my face for about 20 minutes.

I also have deep grooves either side of my face which he told me if they did not disappear he would remove fat from a part of my body and inject it into my face !!!!!Yikes whats going on is this normal or has he cocked it up ?

I did a lot of research before I went ahead with surgery and this guy is the head of the PS department and well respected.

He said he is not sure what to do with the skin that is now hanging from under my chin because if he pulls any more the skin may relax even further !!!!

So here I am back with my turking neck , grooves and a jowel that is slowly beginning to reappear as it seems he has tightened one side of my face more than the other. I am nor a happy bunny and before I see him again have arranged another apointment with another PS for some advice becuase what this doc intends to do to my face scares me...what if he cocks up again ?

Please I need some advice as to is theis normal or has it all gone wrong.

I was invited to a wedding on Sunday but cancelled because my face looks such a mess.

Neive 16 Mar 2012

Reading your posts and more dismayed than ever. I am now six weeks after surgery (minilift and neck lip) have had a a check with my PS three weeks ago. The skin under my chin is like a turkey, but wobbly and tight st the same time. SP told me I had some type of thrombosis in the tendon and to go home and massage it and return in 3 weeks which will be the 27th of this month.

I cannot begin to explain the pain when I try to massage it and in the morning under the chin is so tight I cannot lift up my face for about 20 minutes.

I also have deep grooves either side of my face which he told me if they did not disappear he would remove fat from a part of my body and inject it into my face !!!!!Yikes whats going on is this normal or has he cocked it up ?

I did a lot of research before I went ahead with surgery and this guy is the head of the PS department and well respected.

He said he is not sure what to do with the skin that is now hanging from under my chin because if he pulls any more the skin may relax even further !!!!

So here I am back with my turking neck , grooves and a jowel that is slowly beginning to reappear as it seems he has tightened one side of my face more than the other. I am nor a happy bunny and before I see him again have arranged another apointment with another PS for some advice becuase what this doc intends to do to my face scares me...what if he cocks up again ?

Please I need some advice as to is theis normal or has it all gone wrong.

I was invited to a wedding on Sunday but cancelled because my face looks such a mess.

NHaven 14 Feb 2011

anonymous57 sounds just like me! As my swelling declined my neck and jawline was unchanged. Even at two weeks I realized the face lift was too superficial. At 4 weeks my PS injected botox into my neck muscle so the descending tissue would not be miserably uncomfortable, although he continued to insist I was doing well. By month 4 even he had to admit his approach had not worked. I cried and didn't know if I could handle a redo and if I should use the same PS or just walk away. Well, 3 weeks ago I had the redo. My PS said he tore out the other "do" started over with a full-face lift with a lot of "undermining" of the neck and jaw. Hello...I thought that was what he originally was going to do, but who knows what happens under anesthesia. At first I didn't blame him, but who else screwed up! At any rate, I could tell right away that the revision procedure was great. Obviously my PS had the talent but just cut corners the first time, probably to save an extra hour. And, because the tissue is suspended securely this time, the discomfort is much, much less. I also had to pay an additional $2000+ for the OR and anesthesia but that's less than starting all over with someone new. For me it was better to go for the revision than to live with so much disappointment. For me it was worth it. Good luck to you!

anonymous57 6 Feb 2011

I am still on the fence as to what I will do, having second thoughts as to whether or not my surgeon can actually give me the results that I expect. This is based on what I understand that he will be doing on a revision versus a second opinion with another surgeon.

If money was not an object- i would have my revision done by the PS whom I went to for a consult on my revision. However, the thought have spending another $10,000 +on a revision is quite disturbing.

Getting in writing exactly what my surgeon is planning on doing is a good idea.

I definitely want to have a revision, however, I need to have clarity with my decision.

medskis 29 Jan 2011

Well that is a bit of progress. Have everything in writing as to what will be done and what the result "should" be if all goes well. I realize even the best plans with the best surgeons still can have variations but if you two are on the same page as to WHAT will be done and WHY that is progress. Keep us posted please.

anonymous57 21 Jan 2011

MY PS has agreed with my assessment regarding the laxity of my neck. Now I have to decide if I want him to do my revision. As long as I am very clear with him what I expect and if he feels confident that he can deliver than I will probably have him do my surgery.

anonymous57 21 Jan 2011

Here is something I recently read:
It may help you in discussing this issue with your surgeon. My neck is sagging already as well...
and now I know that my surgeon did not go deep enough to produce the results that I wanted.
This angers me - since if he did not know how to do this surgery- then he should be held accountable for not telling me. I guarantee that if I walked into his office today, for a consult he would tell me that I need a neck-lift.

By Michael Law, MD - Raleigh-Durham Plastic Surgeon. Producing a level and youthful contour below the jawline often requires treatment of the soft tissues that are deep to the subcutaneous fat layer. Through a small, hidden incision below the chin the subcutaneous fat layer is thinned, delineating the anatomy of the platysma muscles which form the two parallel anterior neck ‘bands’ in many patients as early as their forties. The anterior borders of the platysma muscle can be sutured together in the midline of the neck, permanently eliminating the platysma bands and creating a sling effect which lifts and supports the neck soft tissues. This procedure is called a ‘platysmaplasty’. In some patients a prominent fat pad exists deep to the medial border of the platysma muscles which cannot be reduced by liposuction, and if necessary it is directly reduced prior to platysmaplasty to further improve the submandibular contour.

anonymous57 13 Jan 2011

I have since had a second opinion from one of the top PS in my area, who specializes in FL.

To my dismay, he has informed me that my surgeon did not go deep enough into the neck layer. He further told me that I only received a superficial neck lift.

This is quite disturbing since I was very specific with my surgeon as to what I expected from my NL. There is no way he dissected my bands and sewed them back together. I do not want my surgeon to reform a re-do now that I know his skill level will not give me the results that I know are possible.

I am not sure what I am going to do- as a re-do with another surgeon is costly. I should not have to pay another surgeon to fix what my PS did not do.

To be quite frank- I am very angry about this. Plus my PS has not responded to my concerns..

I will keep you posted.
What I learned from this .. ask lots of questions to make certain your surgeon has the skills to preform the surgery that you want. It takes a very skilled surgeon to tighten the neck the right way. There should be no residual laxity, if the surgeon goes deep. It is not about lipo suctioning the fat. it is about going deep into the muscle layers to tighten them up to where they used to be, like a sling. I should not have any bands showing or looseness.
My neck did not have sever sagging, nor was it full.

Stay tuned...

FL721 13 Jan 2011

that's easy to say "ask a lot of questions.." but how do we know what questions to even ask if this is the first time we have ever had this type of surgery. Having plastic surgery isn't something we feel comfortable just discussing in public. We learn as we go along and learn by reading websites like this. I would have never known about how deep a surgeon should go to tighten the neck unless I read your post. When I go back to see my PS I will bring your post with me to see if this is why my neck is sagging already. I just had my FL done in July 2010.

NHaven 24 Feb 2011

My glands descended 2 weeks after SMAS and were very uncomfortable and looked horrible despite botox at week 4. At month 4 my PS agreed to redo and undermine more extensively. Because of this realself site I understood that my PS did a too conservative facelift the first time. While he was very highly respected, I asked all the right questions, followed all of the recommendations...he, basically, screwed up. Now I am 4 weeks post op from the redo and my glands have descended much less and my neck is uniformly tighter. Still, I think he wasn't as schooled as he said. Oh yes, he has all the credentials and a huge following, but in the end I think his technique was and is a little lacking. This redo was scary but because of the better undermining actually hurts less. I think "undermining" is the key. From what I've read I would never surgically reduce the parotid glands.

anonymous57 3 Nov 2010

THank you for the reply.

1. You mentioned your PS said that he wanted to tighten you up. DId this suggestion come from him or from you? I only ask since some PS have such big ego's that they really do not want to admit that they could have gone tighter.

2. I also have read that sometimes tightening has to be done since it can not all be done the first time, as the skin sometimes snaps backs and becomes lax again.

Lots of questions that seem to come up after the fact.
I have not seen my PS is awhile and have a follow-up appointment soon. I am looking forward to having a discussion with him and am hopeful that he sees what I see, and agrees that he has to tighten the neck area more.

I also chose my PS based on strong recommendations from a OR nurse . I also think I may have a gland issue, and my PS did not mention this to me prior to surgery. If I do have the same issue, I wish he had.

medskis 9 Nov 2010

Hi

I'm not sure if the PS guys can really tell in advance what the gland situation is?? I just wish I somehow had known and expectations would have been different.

He suggested the neck skin tightening and the platysmal band incision ....actually he might have mentioned the platysmals first and then said while he was at it he would do a little more tightening. I think his overall approach is conservative first time out and then to do a revision about a year out if called for. GOOD LUCK to you.

BrittB 9 Nov 2010

Hi Medskis,

Thanks for the info, always useful to the community. Stay in touch.

-Britt

anonymous57 28 Dec 2010

I am almost 6 month after surgery and very disappointed with the way my neck looks. My bands are prominent and there is a fullness on either side of my jaw that looks like my jowels have returned. I have also the cords scars under my chin.

My neck still looks crepey and after spending over $10,000.. I am not happy. That is an understatement.

My surgeon has been unresponsive to me which is infuriating me further. I do not understand this.He has a stellar reputation and is board certified, working in a plush NY city office.

What about patient satisfaction??? This should be of the utmost concern to a surgeon. Would't you think?
Or does he think is beyond this and his ego is in his way? UGH!! I am so frustrated.

I will be seeing him next month.

I have also had 2 Titan treatments, 2 lymphatic massages.. nothing seems to change.

I've also made an appointment with a another PS for a consult to see what he thinks.

The rest of my face looks good.

medskis 5 Jan 2011

To Anonymous57 ... how does your PS feel about re-do's? Any mention or suggestion of that. My PS was pretty up front about that at the same point you are ...ie, he said that if we got closer to the one year point and certain improvements had not been realized through the healing process he would schedule a second procedure .... when he did for me, his main goal was to incise the platysmal bands this time so they would not show so much, and to tighten up the neck skin a bit more ...when he examined me on the day of the redo he also thought I might have popped a stitch the first time which made the neck skin a little looser than it should have been. As of today I am 9 months out from the redo ...still have some tightness around where those darn large glands are - certainly improved but not the clean look I would have had if the glands did not show those bulges . I will be curious to see if any difference at the full one year mark. Bottom line for you though is to pursue a touch up if the situation really merits it. You will have to pay for hospital OR time and anesthesia but should not have to pay surgeon fee. I think the surgeons want you to feel good / look good too because it is their name and reputation that is impacted in the word of mouth process. Best of luck.

FL721 5 Jan 2011

The same thing happened to me but my PS was pretty upfront with me from my first visit - he did not give me unrealistic expectations. I did not expect that I would look perfect - just better. I am considering having this fixed since I spent $12,000 for my FL and I have this rebound thing too. Read more below.

This is copied from this website.
http://exploreplasticsurgery.com/category/submentoplasty/

You can read more by going to the website. This can happened to any patient over the age of 35 because we don't have the elasticity in our skin like a young person.

This is called rebound relaxation. This is the change in the neck that will happen to some patients six to twelve months after their initial facelift. This may appear as looseness of the central neck skin, the appearance of lumps or fat areas along the jowls and submandibular areas, and recurrence of platysmal bands. These developments are unsettling to patients as they understandably believed that their relatively recent effort physical and economic sacrifices would provide a more long lasting effect.

In reality, and I advise all my Indianapolis facelift patients, that bothersome rebound neck relaxation will happen in about 10% to 15% of patients. It is more likely in patients with fuller necks and more severe neck sagging but not exclusively so.

anonymous57 18 Oct 2010

medskis..

What does your PS mean by scar cords?
Where are you massaging?

When you had the revision did you only have your neck done? How was the recovery compared to your first surgery. I know that healing takes time and that we are very impatient by nature.

I too, want my neck to resolve quicker than it is. Maybe it will get better maybe it will not. If not than I will want a revision. Since this is the area of most concern for me.

I understand about the glands. As I mentioned before I was told the result due to my glands would not be as clean unless I had the glands dissected. Interesting only one surgeon said that he would do this. The other surgeons said that they would push the gland up more. Not sure what this means.

Are you in the East or West Coast? How many consults did you have prior to surgery. I had 6.
I have to stop second guessing my choice of surgeon.

medskis 25 Oct 2010

hello again - answering the Oct 18th questions:
1- Scar Cords ..... maybe that is what some of the folks are calling ridges? In my most recent case, my PS pointed to the middle of my neck where he had made the one inch incision to be able to snip the long platysmal bands and told me massaging would help soften up some scar cords under the skin ..... I remember after my first surgery in 2009 that he said they usually soften up starting at about 5 weeks (scar cords in general) and massaging always helps breaks them down.
2- Revision compared to first surgery.... besides doing the platysmals during the revision, my PS also reopened the original behind the ears scars to do more tightening. I thought the discomfort in THOSE 2 areas was a little worse this time vs the first. However, I rarely take any of the stronger pain meds just because I do not want to start to rely on them so maybe if I had taken those the swelling there would not have bothered me as much as it did.
3- Glands -- no one mentioned pushing glands UP ... my PS had only said he would not recommend removal.
4- East Coast big city. I chose my surgeon because a dear friend had been a nurse in the OR plastic surgery area of a top hospital and she had originally given me 3 names if I were ever to have PS. I figured she got to see them all in action and really would know. One retired since and the other 2 both are always mentioned in the TOP DOCS for PS in our city magazine. One had a friendlier bedside manner and I could walk to his office. No complaints other than the glands bulges came as a post surgery surprise to me and they won't go away so they take away from the results I had hoped to have otherwise. The ENT specialist said everything is normal, some folks just have glands that hang lower than others but this is something that would be good to know before surgery so you could adjust expectations.

cateloveskinerase 18 Oct 2010

Did she ever say who her surgeon was? The lady who started this thread, Dee?

e1948 17 Oct 2010

Good luck!!!!

anonymous57 16 Oct 2010

Medskis.. Interesting.
I also had a Face and Necklift almost 3 months ago. I can still see my platsyma muscle and have swollen glands on either side of my neck. One side is worse than the other. I know my glands are large to begin with. Some of the PS I had consults with suggested dissecting the glands for a cleaner look. Apparently they push them up.
Yet this seems to be a controversial procedure. My PS does not do it due to possible complications. I am hoping the swelling will subside. I do think I will need a touch up because my neck is not as tight as I hoped it would be. This is disappointing. It is better.. but I was not planning on seeing any banding. My PS also is known for a "natural look" however, sometimes perhaps those surgeons do not tighten as much as they should. I guess perhaps it is better to tighten less and go back in to tighten more.. rather than tighten too much. Yet.. I would rather not have to spend the 2K to get a re-touch.

I am told that recovery is a process and that the neck area is last area to resolve. Yes, recovery takes a lot longer than I had anticipated. It is difficult to not hyper-focus on the recovery and all the lumps, swelling, and imperfections we see after we spend so much $$$$ on our facelifts.
I am just hoping that mine also resolves with time. I do not want to have to have Botox injections for banding!!!

medskis 18 Oct 2010

My PS also said he would do nothing with the glands -not recommended! It's my sub-mandibulars that show as bulges, sometimes more, sometimes less. It IS disappointing and they detract from the otherwise now clean jowl/chin area and tighter neck. The revision at the 1 year mark incised the platysmals but at the 6 month followup that I just had for the revision surgery, my PS asked me to keep massaging the area because he could see some scar cords that should go away in time. I am such a slow healer. However it is disappointing and not predictable if you happen to be someone whose glands will show more prominently after the lifts/tightening. I should also say that I thought the recovery right after the revision surgery was a little more painful with swelling on the behind the ears scars that had been reopened to do more neck tightening. MY PS has a top notch reputation in a big city but this is just how things evolved with me. I do have an improved look and most of the turkey neck is gone but it has been disappointing that no one really has noticed a change or said anything unless they knew I was having the surgery. I am lucky though I do not look my age (just turned 60), but I did not before the surgery either .... I think I project young since I am energetic and thin and have longer hair that probably covered up the jowls enough that most people weren't really as focused on it as I was. I am still hoping for some additional improvement since I heal so slowly and maybe there is still a little swelling to subside. I never had any ridges though.