Deep plane face lift, Neck lift & platysmal resection (Photo)

Hello, hope you are well. The areas of maximal fullness appear to be under the jaw on both sides of the neck with fair symmetry. These areas are where the submandibular salivary glands live. They are sometimes contoured during a deep neck lift, but if they remain enlarged after surgery it can create this appearance. Before delving back into any revision surgery, I would suggest applying Botox to the glands periodically to cause some atrophy and shrink them down. If that is effective, you will have pinpointed the issue in a very low risk manner and can then go from there.
Best,Dr. Tower

Thank you for your question and for sharing your photographs. I did not understand from your question whether you had a deep plane neck lift or not. A full neck lift is a description that may or may not encompass this aspect. The fullness that is still present under the chin typically suggests the volume of the digastric muscles or the submandibular glands, or a combination of the two.

If this is the reason behind the problem you’re experiencing, it will not be addressed by non-surgical treatments. To ensure the correct diagnosis of the underlying anatomy, an ultrasound scan while sitting up is likely to be a reasonable option. It is relatively fast and moderately priced. A sitting MRI scan can also provide answers, but it is a more expensive investigation.

Depending on the findings, it may be necessary to address the contours using surgery for additional reduction of the digastric muscles and submandibular glands, or if it happens that the volume is superficial, a small amount of liposuction may be able to control it.

From the photos, I would guess that you need a more thorough face/neck lift but it has to be done under local with a little iv sedation for complete comfort. This way you can be sat up so the doc can fine tune the results easily and you don't have any tube in your mouth like when you get it done under the old method of general anesthesia.

Your photos show that you may have residual deep neck fat and enlarged submandibular glands that contribute to the bulging appearance. Follow up with your plastic surgeon and ask if he/she would consider re-exploring your neck. Alternatively, seek out an experienced surgeon who specializes in neck lifts to evaluate you. All the best!

Your photos are still rather limited, but it does appear that you have a recessive chin, residual fat deposits in your neck, and probably submaxillary gland enlargement. Placement of a chin implant along with a lower face and neck lift can accomplish improvement of all of these issues. Choose your second surgeon wisely based on extensive experience.

Based on the long series of photos you have sub, mandibular, glandis noted. Best to obtain facial ultrasound to secure this diagnosis. Non-invasive treatment would be Botox injections, ultrasound, guided into the gland itself in a series of every three months to see if reduction of the size of the gland can occur fee for the sessions is $2000 per session. The next option would be a complete skin revision facelift neck, with muscle plication of neck muscles. Fee $25,000 since it’s a revision. During that procedure direct injection of Botox to the submandibular gland could be done. Option three would be bilateral or unilateral sub mandibular gland excision. Best virtual consult with.