Disappointed with results of SMAS lower face/neck lift. Can my neck be improved? (photos)

I am three months post surgery from a SMAS lower facelift. My neck had very little improvement and I expected a better result. As time goes on, my neck skin gets looser. I took very good care of myself post surgery. I am not overweight or a smoker. I am very disappointed. Can my neck be improved?

Doctor Answers 14

Disappointing result with SMAS lower face/neck lift in the neck.

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Thank you for your question.

I have to say that a perfect result after face lifting under the neck is not always easy to achieve; I normally discuss this in some depth with my patients. The results can be improved but then a more aggressive neck lifting procedure is required or even a formal platysmaplasty to deal with the bowstringing muscle bands in the neck. 

If still present after surgery there are a number of options available including Botox, minimal or no incision division of the bands by sutural techniques to divide the muscle bands or more formal open correction of the muscle bands. 

I hope that was useful information for you.

Best wishes

Cambridge Plastic Surgeon

Neck improvement

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Dissection from one side of the face to the other via the submental area should correct any skin irregularities or bands.  Sometimes this requires pretty wide skin undermining to properly correct the neck.  

Improving the Results of the Neck in A Facelift

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The Neck portion of the facelift is often the most difficult aspect of the procedure. If not performed properly, patients can be disappointed, as you are. 

The key is whether or not two things were performed, a good snug pull on the deep neck tissues up behind the ears and a good snug treatment of the neck in the mid line (under your chin and down towards the Adam's Apple). 

Ask your surgeon what approach he/she used and see if any improvements can be expected.

James Bonaparte, MD, MSc, FRCSC
Facial Cosmetic Surgery
Ottawa, Ontario, Canada 

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

SMAS Facelift | Platysmal Bands and Neck Skin Laxity

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Thank you for your question about SMAS facelift.

Did you have an incision underneath your chin in addition to incisions by the ears?  Often, aggressive work centrally needs to be done to address the under-chin area and central platysmal bands.

You may discuss possible facelift revision with your plastic surgeon.  If you have it redone, I would wait about one year.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

SMAS facelift

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Unless the neck was treated directly, a SMAS facelift will have very little effect . Sometimes a flap of SMAS is rotated to the mastoid region.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Disappointment following facial rejuvenation.

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Hello, and thank you for your request. I am sorry to hear that you're still having problems following your procedure. It is difficult based upon the pictures were shown to see her overall result. I do believe the photo exposure seems to be different and you do have some skin aging changes that may be improved with a good medical aesthetician. I would recommend to follow up with your treating surgeon to discuss all of these findings. Best a block.

John J. O`Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 31 reviews

Is my neck as good as it can be 3 months after my lower #facelift?

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Thank you for your picture.

I agree that your neck has been improved yet not as good as you might have expected.

Was the front part of the neck opened and the muscle repair?  There are controversies in opening or not the front of the neck but I open most anterior necks in my practice.  If it was not done, perhaps it could be contemplated; it is a simple procedure on itself and can be done under local anesthesia and IV sedation.

It would be good to have the OR note prior to recommending a treatment but if the anterior neck was already done, you might need another SMAS-skin correction.

Best regards.

Marc DuPéré, MD
Toronto Plastic Surgeon
4.8 out of 5 stars 71 reviews


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Thank you for the question and photos but a review of your operative note is really needed to see what was and what wasn't done before making a recommendation.  So get the note and see some experts in the field

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Unhappy with neck lift 3 months after surgery

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Thank you for asking about your SMAS face lift.

  • I am so sorry you are disappointed.
  • The photos show visible neck improvement, although obviously not enough to satisfy you.
  • The photos suggest the problem is your skin itself which appears to be thin, with loss of elasticity.
  • One approach would be redraping of the skin under the chin.
  • But at times, a TCA peel or a laser will give more improvement that further surgery but an examination is needed.
  • Discuss your options with your surgeon to see what seems the better approach for you.

Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Disappointed with neck after surgery

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Hi ARSatty, I see the area of the neck that you are concerned with. Often times this is related to the quality of the skin rather than the underlying muscle. In my practice I would advise that you wait for a couple more months to see how things heal. If you are still dissatisfied I would discuss your concerns with your surgeon and determine if a revision would be helpful.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.