I am updating my question with photos. What can I do about my neck?
Doctor Answers 17
Banding in the neck after a facelift
Falling necks after 2-4 months typically will happen after a lower facelift without a proper necklift
A lower facelift is essentially a mini-facelift. There are incisions around the front and back of the ears. The deeper tissues called the SMAS are tightened from the sides of the face, but very little if anything is performed under the chin. The lifting from the sides can make the neck look good initially, but as the SMAS tightening relaxes, the neck will fall. Your last photo does not appear to have any incision under the chin, or perhaps only liposuction was performed in which case the incision may have been closed with a single stitch.
Some surgeons will pair some liposuction under the chin with a mini-facelift or lower facelift when the patient has a single area of sagging skin under their chin AKA turkey neck or wattle. This single area of sagging neck skin is not what it appears to be. It is not just skin and fat, but there is a component of platysma muscle bands or muscle cords within this wattle. This is why it is important to perform a necklift along with a lower facelift. A necklift is composed of some liposuction if there is excess fat, but in your case your neck already looks very thin, so I may not perform any liposuction to not overly remove fat from the skin under your chin, and tighten the platysma muscle under the chin in a procedure called a platysmaplasty. Any fat under the platysma muscle is fair game, but the fat directly under the skin (subcutaneous fat) is more precious and helpful in minimizing crepiness of the neck skin.
To improve the vertical bands on your neck and loose skin would require horizontal incision under the chin where the chin wrinkle is located, approximately 1/2"-3/4" long. This gives access to the vertical muscle cords under the chins which need to be sewn together as a corset platysmaplasty. Then to further smooth out the skin under the chin, the incision around the front and back of the ears ideally would need to be reopened to further smooth out the extra skin through those incisions.
You should talk to your surgeon and ask if a platysmaplasty was performed and if he or she is able to perform a platysmaplasty. Some surgeons perform a wide variety of plastic surgery procedures and may not offer a platysmaplasty. Keep the lines of communication open, and most surgeons are more than will to take care of their patients, especially if they know that they are posting their reviews and questions on Realself.
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Facelift and neck issue
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You should expect a better result from a facelift regarding your neck.
Neck bands such as these are difficult to correct
In general, after surgery the swelling present in the healing process can make things look tighter and smoother. As swelling recedes and the tissues relax it is not uncommon to see some return of the laxity in the central neck skin. In your case it looks like there was too much recurrence of central neck skin laxity. If it is just skin laxity then there are two options, revising the surgery to pull more of the skin laterally, or as would be my preference, directly excising the excess skin through a discrete incision in the central neck that will give improved contour and tightening.
Neck Changes after a facelift and necklift
Neck banding after a facelift
Recurrent neck banding after facelift
I have done many different operations to address or prevent this including suture suspension gortex suspension, platysmaplasty, revision platysmaplasty, revision skin excision and directly cutting out the skin under the neck. None of them are completely satisfactory in either preventing or treating other than directly cutting out the skin.
Realistic expectations from patients and by doctors would go a long way towards overall higher patient satisfaction. I have had patients fly to so called world famous surgeons for revision neck lifts and the skin was pulled very tight ultimately leading to no significant long term improvement but some pretty nasty hypertrophic scars from the tension that I have had to deal with.
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.