3 chins after neck lift revision, what can be done? (Photo)

Question

Hi, I had a neck lift in Feb 2021 and the results left me with a mottled chin. The doctor did a revision in Feb of 2022 and now I have two bands coming down the sides of my chin. There is still plenty of skin to be pinched. What can be done?

Randal Haworth, MD, FACS · Answer

I'm sorry to hear that you're experiencing issues after your neck lift procedure. It's important to consult with your doctor or a qualified plastic surgeon to discuss your concerns and explore your options.

Based on your description and photo, it's possible that you may need a further revision surgery to address the bands on the sides of your chin and the excess skin. However, your doctor will need to examine you and evaluate your unique situation to determine the best course of action.

It's important to communicate your concerns openly and honestly with your doctor, and to ask any questions you may have about the procedure and what to expect in terms of results and recovery. You may also want to consider seeking a second opinion from another qualified plastic surgeon to ensure that you are fully informed about your options.

In any case, it's important to be patient and allow sufficient time for your body to heal before undergoing any additional procedures. Follow your doctor's instructions for aftercare and be sure to take care of yourself both physically and emotionally during this process.

Jason Emer, MD · Answer

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.

Gianfranco Frojo, MD · Answer

This is a "cobra neck deformity". This is quite common when a necklift is not executed properly. I would recommend a revisionary necklift procedure to excise the scar and restore a unified, harmonious look to the neck. This deformity is something that can happen from over-resection of the fat in the midline and inadequate repair of the platysma muscle in the midline (or eventual separation of the two muscle bellies of the platysma).  I recommend seeing a plastic surgeon with at least 6 years of integrated plastic surgery training and ideally an additional year of aesthetic surgery fellowship training.

Zoran Potparic, MD · Answer

It would be very difficult to give you sound advise based only on this photo; in person evaluation is needed. It is quite possible that lower face/neck lift may be a better procedure at this time since it will allow for better exposure to treat platysma muscle defomity, scars, possibly submandibular glands. In person consultation with a board certified plastic surgeon, expert in face/neck lifts, is recommended. Good luck.

Brian K. Machida, MD, FACS · Answer

The problem is not with persistent loose skin.  After two surgeries, your submental neck has become skeletonized due to the loss of a fat layer to hide irregularities.  The swelling on both sides may be due to the prominence of the submandibular glands or anterior digastric muscle.  You will need another surgery, but it cannot be more of the same.  You should see other opinions, and if their plan is to do a platysmaplasty medial tightening and a lateral neck platysmal tightening, it's likely you already had it done. Your next doctor needs to address what's under the muscle.

Philip S. Schoenfeld, MD, FACS · Answer

From the photo that you have provided it appears that you have what is called a "Cobra Neck Deformity".  This is the result of removal of fat from above the platysma muscle and below the platysma muscle without reapproximating the platysma muscle.  A further revision can help with this issue but a thorough examination will help reveal what all of the issues are that would need to be addressed.

Derek Fletcher, MD · Answer

It looks like the platysmaplasty (platysma muscle repair) failed.  However, an in person exam and a review of the operative reports is necessary determine what was done and what is the best strategy to improve your result.

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