8 months post op - am I experiencing cobra neck deformity? (photos)

Question

I had a lower facelift including neck lift by an experienced Boston plastic surgeon 8 months ago. I’m not happy with the skin still hanging down on my neck and there is a hollow area between the two folds that really bothers me. Is this cobra neck deformity that occurs when a neck lift is botched? Would most women be happy with this result? I have made an appointment to see the surgeon who did the procedure but at my last follow up with him he seemed to think that this was the best it could be.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  It appears the medial edges of your platysma muscles either were not sutured together or separated after your surgery.  To form a “hammock” across your neck, and give the best neck contour, excess fat under the platysma is contoured and the  medial edges of the platysma muscle are sutured together.  The lateral part of the platysma is then partially elevated and advanced superiorly/posteriorly to smooth the neck contour.  A revision should be able to improved your result, taking into account that revision surgery is slightly more difficult due to the scarring in the area.  Best wishes.

Gianfranco Frojo, MD · Answer

This is definitely a result of over excessive removal of deep fat in between the platysmal muscle bellies. This can be fixed using a deep interplatsymal fat pad suture in between the platysma muscle bellies and then re-approximating the muscle bellies to each other. This was described by Aursvald from Brazil. This is how I fix cobra neck deformities that come to my practice. You need a highly experienced American Board of Plastic Surgery certified surgeon that specializes in revisionary facelift/necklift surgery.

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs. Without comparative images showing the appearance of your neck prior to the intervention, it is more challenging to fully qualify the result. However, based on your current images, the primary issue appears to be related to the platysma muscles and, to some degree, to the volume lateral to the midline. This corresponds to the digastric muscles and the lower part of the submandibular glands.

Volume reduction further laterally, beneath the platysma, can help improve the overall balance of the neck contour. However, on its own, this approach does not completely address the visibility of the platysma bands. Treating platysma bands can be particularly challenging, especially in individuals who have very active expression in the area beneath the chin during speech.

A combination of treatments, including procedures targeting the platysma, division of certain muscle fibres, and lateral suspension, are part of the available options to manage these concerns. It is worth noting, though, that in some cases, a small amount of banding may persist.

That said, if lateral volume is reduced more significantly, the bands often become less prominent. This occurs because the reference plane of the contour under the chin moves upward and is better hidden by the mandibular outline.

Brian K. Machida, MD, FACS · Answer

You have platysmal bands.  I can't tell if you had a platysmplasty.  This is not botched. If you had a plasytsmaplasty, more needs to be done to address the bands.   If you hadn't had a platsymaplasty, then one might need to be done.

Rajaie Hazboun, MD, MBA · Answer

Thank you Nikki for posting your question here!I will start by stating that my answer is based on the limited information and pictures presented for a more accurate analysis and a bespoke plan I would recommend consulting with your plastic surgeon.
I am sorry that your are unsatisfied with your outcome. From the pictures it does appear that you might have a cobra neck deformity though I cannot conclusively say that without an exam. If those lines that are showing on the pictures are the edges of your platysma muscle then it is , if they are skin folds then it is more likely skin redundancy . If it is a cobra neck deformity it could have happened as a result of multiple factors I will state a couple:- too much deep fat was taken between the edges of the platysma muscles- the edges of the platysma muscles were not brought together in the midline or they were but the sutures that were holding them in place broke down or came apart .
That being said if you are not satisfied with the outcome I would discuss your concerns with your surgeon, this can be resolved with a revision that can be done through the same incisions.
I hope this helps, best of luck!

8 months post op - am I experiencing cobra neck deformity? (photos)

Answers (7)

Answer: Platymal bands, not a cobra neck deformity

Answer: Platymal bands, not a cobra neck deformity

Answer: Cobra Neck Deformity

Answer: Cobra Neck Deformity

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Everything you need to know about Neck Lift

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8 months post op - am I experiencing cobra neck deformity? (photos)

Answers (7)

Answer: Platymal bands, not a cobra neck deformity

Answer: Platymal bands, not a cobra neck deformity

Answer: Cobra Neck Deformity

Answer: Cobra Neck Deformity

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Recommended reading

Everything you need to know about Neck Lift

Our mission is to create a world where every investment in modern beauty is Worth It.