Do I need a neck lift revision? (Photo)

Question

I am 37 and I had a neck lift with lipo and corset platysmaplasty one year ago. I still have loose skin under my neck and can see the muscle banding under my chin. I was not happy with the results accept on my jaw line. The doctor said I had to wait a year to see full results and the muscles needed time to grow together. I have tried Viora radiofrequency and botox to help tighten the skin but the results were very temporary. What are my options?

Evan Ransom, MD, FACS · Answer

Thank you for the questions and the photos. There are limitations to the utility of neck lifting without skin excision. Tightening the muscles under the chin and removing a little fat can be a great treatment. However, if there is excess skin, and this loose skin is still there afterward, you can have a recurrence of sagging. This is a difficult problem in younger patients, because you aren't really ready yet for a lower facelift... but have some extra skin. One solution is to do a small submental skin excision. With a well-executed closure, this can hide quite nicely. Another option is to use a minimally-invasive tightening device. In my practice, I use the ThermiTight treatment for patients such as yourself. Take care and best of luck!

Jed H. Horowitz, MD, FACS · Answer

It's best to begin by consulting with a surgeon in-person. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine what treatments will best rejuvenate your neck . 
During your initial examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend non-surgical alternatives to address your concern. Consulting with a board-certified plastic surgeon who specializes in #neck lift procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Brian K. Machida, MD, FACS · Answer

If you had a corsette platysmaplasty, either the suture loosened or it was not carried inferiorly as far as you expected. I would approach this by doing another platysmaplasty and a full facelift to get better definition along the mandible. A non surgical option would not be sufficient.

Andrew Kornstein, MD, FACS · Answer

When you say a necklift (with lipo) and corset platysmaplasty, do you mean a "corset platysmaplasty neck lift"(incision under chin) or a neck lift(incisions around earlobe and in back of ear)as well as a corset submental muscle tightening? From the pictures it appears to be the former. Your platysma muscle appears to have residual laxity; perhaps there is lateral laxity(as opposed to purely submental laxity)? Your failed attempt to tighten the skin and weaken the muscle appear to confirm this observation.If not already performed, a formal neck lift(ear incisions) should remedy the situation.Hope this helps.

Donald Nunn, MD (retired) · Answer

I believe you would benefit from a revision.  Things are unlikely to improve if a year has elapsed.  Discuss with your surgeon.  Good luck.  Donald R Nunn MD   Atlanta Plastic Surgeon

Do I need a neck lift revision? (Photo)

Answers (5)

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