Neck lift revision - what would need to be done to fix this? (photos)

Your photo shows a vertical sagging band just to the left of your center neckline in the photo on the right. Presumably this represents a low hanging platysma muscle border (band). The fullness just under your jawline on each side could be due to submandibular salivary gland fullness that sometimes becomes more noticeable after tightening the neck and removing some fat in the area, unless the gland is partially removed at surgery. Not every surgeon feels comfortable removing the submandibular glands as the technique carries risks of nerve and blood vessel injury. The platysma muscle band can be corrected easily through in incision just under the chin, but you need to have a thorough discussion about your concerns with your surgeon.

In your “before” photo, there is evidence of excessive fat under your chin. I also see that your jawline had pronounced jowling that manifests as a “W” shape on the jawline. These two areas have definitely been improved. What you might be seeing is that the fat under the jawline helped to mask the prominence of the platysmal bands, and with its removal, the bands became more visible. I have just returned from the annual plastic surgical meeting of ASAPS, and many surgeons spoke about their problems with the recurrence of platysmal bands. In my practice, I have not experienced this, but every surgeon has different techniques, and your surgeon likely used a technique that led to this recurrence. The “fix” might be something as minor as Botox, but an in-person consultation would be needed to properly assess what would be the best modality to improve your current result. Please know that improvement is possible.

It takes an average of 1 year for result of face lift to settle and mature. Lumpiness, irregularities, internal and external scars need to soften and flatten; very frequent occurrence is visibility of anterior neck bands, even if aggressive platysmoplasty was performed? An easy treatment for that secondary "deformity" may be Botox; in some cases, revision with excision of the band/scar may be needed. Try to stay patient few more months, talk to your surgeon about your options and seek, if needed, second opinion consultation with another plastic surgeon. Good luck.