Would Botox Alleviate Noose-sensation After a Neck Lift?

I had a neck lift 2 years ago. For about 6 mths I experienced a noose-like feeling, that eventually (mostly) went away. I recently had back surgery (they suspend you neck down) & the noose is back with a vengence. I tried NSAIDs, prednisone, local triamcinolone and nothing is working. The sensation of gagging is horrible & it is making it impossible to work or focus on anything. Even going for a walk (that is needed to recover from back surgery) exacerbates the noose. Any advice??

Doctor Answers 6

Botox For Noose-sensation?

I recommend scheduling a follow up with the surgeon who performed the procedure as the sensation you’re describing normally subsides this far post surgery. It is possible you have a permanent suture in place to help suspend your neck, which has been known to cause this strangulation sensation in some patients. When you see your surgeon, inquire about possibly removing that suture if in fact you do have one as that should relieve the discomfort whereas Botox would not help in a situation like this. “Dr. D”

Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Noose-sensation After a Neck Lift Unusual

Although common right after surgery, the noose-sensation this far after standard facelift and platysmaplasty surgery is quite unusual.  You may indeed have a suspension stitch across your neck that is still tight, however.  A review of your operative report or your surgeon will be able to help answer that question.  I doubt that Botox will help.

Randy J. Buckspan, MD
Austin Plastic Surgeon
4.6 out of 5 stars 9 reviews

Would Botox Alleviate Noose-sensation After a Neck Lift?

 The sensation of having a noose across the neck might indicate that a suspension suture was used during your Neck and Face Lift.  In this technique a thick permanent suture is placed from one end of the neck across to the other creating a strangulation-type sensation in some patients.  The typical Platysmal band suturing should not have this pronounced of an effect and certainly would not recur some 2 years after the Neck Lift.  

 If the symptoms persist, you might try Botox but high doses can cause difficulty swallowing that might worsen the sensation.  You might have to have a local, revision Neck Lift through an incision under the chin to release any permanent suspension suture (s).

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Noose Feeling after Neck Lift and Botox

   If the noose feeling is due to an anterior platysmaplasty where the platysma is tightened, Botox to relax the muscle may be reasonable.  A physical exam with and without animation would be necessary to determine appropriateness.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Noose-like feeling

If your feeling is related to the recent spine surgery it may not be a bad idea to just give it some time to improve.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Botox unlikely to help but no harm in trying


Thank you for the question.  Your symptoms may be related to a permanent type suture used to suspend your neck.  If that is the case removal or cutting of that suture would be the ideal treatment for your symptoms.  Botox is not likely to help, however it will not do any harm in trying it.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

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.