4 months post op Lower Face Lift, my neck is sagging. Do you think the surgeon didn't make it tight enough in the beginning?

I appreciate your question and without a doubt, this is the most common question with a Face/neck lift. Often after a neck lift, you get a touch of loose skin, this is common and may resolve over time. However, its no guarantee. With respect to the banding, this is likely what is known as platysmal banding. these are the ends of two muscles that cover each side of your neck. When we do a neck/face lift we often stich these together or even cut them. Surgeons often disagree on the best way to manage these however, the key point is that once you remove fat in your neck, you can often see these if they were not cut or sown together. Even if you stich them, the stiches can come loose and you can see them again. There are ways to fix this after surgery and I'd suggest you speak with your physician. Hope things work out for you,Dr Bonaparte

is completely normal. I review all of my facelift patients specifically at 3 months to assess this. Often it is minimal and does depend on the technique used to lift the soft tissues.I suspect the parallel bands you see above the adams apple are a the platysma muscle that almost always separates in the midline. I often perform a midline platysmaplasty at the same time as the initial facelift to prevent this occurence. They would have been there before your facelift but were masked by soft tissue descent. The lateral pull on the platysma without addressing them centrally, and the associated repositioning of the lower face soft tissue will have made them more apparent. It is an easy fix, but I would discuss this with your surgeon.All the best

It is normal for the skin to loosen up after necklift. Typically it looks tight initially and the relaxation helps make the results look more natural. It is unclear what the neck bands are, they sound like they are horizontal. Is that from the direction of pull? I would direct that question - as well as any others - to your surgeon. It may take a couple more months for the results to soften further.

Your surgeon is correct. There is always some loosening of the tissue following any cosmetic surgery. This is due to a variety of different factors but in fact the swelling which recedes following surgery will take several weeks to abate. You will notice some loosening. In fact I tell my patients that they may experience excessive tightness until the swelling is gone. I believe that this is a benefit to the patient meaning that as the tissue loosens it becomes comfortable but begins to look more natural. Interestingly, there is a reference in the plastic surgery literature to the fact that patients may need two facelifts, the second following the first by about 6 months in order to correct this residual laxity which almost always occurs. Certainly this could be surgically retightened. There may be other ways to help it including laser or even the new ThermiTight procedure.