Bad neck lift? Jowls still showing (Photo)

Thank you for sharing your question and photos. You have some residual excess skin in the neck. There are several reasons why this might be. But, I don't see anything egregiously wrong here. About 1-2% of all patients presenting for necklift may require some additional procedure to "tighten" the laxity, especially in this area. I see this problem most frequently when a platysmaplasty was performed at the same time as the necklift and the neck skin was re-draped (or tailored) in a suboptimal fashion. It seems to be a common issue. The correction is surgical and is either fixed under local anesthesia or general anesthesia, depending on how extensive the correction. An experience facelift / necklift surgeon can tell you based on a thorough physical exam. Next step is to consult with an experience and board certified surgeon specializing in necklift and facelift surgery.
Kind regards,
Dr. Harmych

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question. Neuromodulators like Botox are often a good treatment for platysmal bands, as they target the platysma muscle that is responsible for the formation of these bands. Facial fillers can also be used to lift sagging skin while smoothing wrinkles and fine lines. Finally, RF microneedling is an effective way to rejuvenate the skin at a cellular level, by boosting the body's production of collagen. I recommend scheduling an in-person consultation with an experienced, board-certified physician who can assess your needs on a more individual basis and help you consider your best cosmetic options.

Unfortunately, it is not unusual to see platysma muscle bands after face/neck lift. Platysma is working, functional muscle, that continues to contract even after significant portion of muscle is transected or removed. You may try Botox to diminish bands visibility. Jowls, which I do not see that clearly, may be addressed with liposuction with small cannula. Elasticity of your skin and deep skin creases also contribute to overall appearance. In person consultation with a board certified plastic surgeon, expert in face lifts, second opinion, is recommended. Good luck.

You have 2 widely spaced platysmal bands which cannot be remedied by a platysmaplasty. Jowls look worse when looking down. In the head neutral position, your neck profile is not bad, which is how results are evaluated (in the head neutral position).
I don’t have any pre op photos so I can’t tell your starting point. It’s been two years and we hope lifts last many years. But your skin looks like it’s lost elasticity which the the main reason for loosening.

A SMAS plication may not get your desired result on the platysmal bands but will help your jowls. Going back into a deep plane can be done but it depends on the surgeon, but your best bet with regard to those bands is a deep plane lift.