13 weeks out from lower face/neck lift. Have cording and hard lumps under chin - how do I fix this or will it go away? (photo)

There appears to be significant swelling within the skin. Some of those is expected after a facelift. Thermal damage created by a laser or ultrasound can create a problem that will take considerably longer to resolve. Do You know whether or not the skin was treated with a laser or ultrasound?

Although time should be helpful I would recommend starting steroid injections at 3 months to try to alleviate some of the problem. You will probably require revision surgery at the 6 month mark and that helps. Some of this advice is based on generalities because we do not the exact type procedure performed.

Thanks for the pictures.  I would agree with your plastic surgeon.  Time is the best treatment to allow the area to soften.

I am imagining that you underwent a face and neck lift, as this can be a common problem with what is termed a "corset platysmaplasty."  It is still too early to judge the results, but often times while my patients are waiting for healing to occur, I will inject Botox into the platysmal muscles to temporarily relieve the "cords."  You will need to wait 2-3 more months in order to determine whether a revision will be necessary.

It is still early in the healing process to tell if a revision will be necessary. Please keep up the massages as suggested by your surgeon and continue to follow up with them.

Dear Braxton06:Thanks for sharing your photos. Please forgive me for copying the complete reply from another posted question. The last half will pertain to you. I hope it helps you!

This is a universal concern and very reasonable
question for all patients to understand.

There is
a dynamic and similar course of healing everyone goes through following surgery
or an injury.

Physiologically,
any incision or puncture of the skin will cause bleeding and bruising. The
length of the incision and amount of lift or undermining determine the
magnitude of the healing to occur. More surgery means more bruising, swelling
and potential side-effects or complications but the healing time is similar and
that is because the “army” of healing cells and scar formation is the same for
any injury.
Please
anticipate:

1.Swelling and bruising for 10 days to 3 weeks. Options to help
hasten the reduction in swelling include:1.Head elevation above your heart level.2.Iced compresses on non-flap areas. NO direct ice anywhere. 3.Gentle ambulation with no exertion and no bending. 4.Arnica montana a herbal product is very well marketed and has
both anti-oxidant and questionable anti-bruising effects.5.Bromelain is the active enzyme which assists in the breakdown of
bruising. It is found in fresh pineapple. I have found this to help patients.6.If necessary for swelling, particularly in patients with histamine
response to seasonal allergens, try OTC anti-histamines such as Claritin
(loratidine) or Zyrtec (certidine).7.For more swelling, a Medrol dose pack may help but must be prescribed
from your surgeon.8. Low dose ibuprofen (after 3 weeks) at 200 mg twice daily has also been helpful for my patients. 



2.Potential bleeding complications and incision concerns during
the first 3 weeks

3.Under the skin firming, lumpiness and irregularity during the
first 3 months

I
separate 2 levels of activity for my patients.


1.ADL: activities of daily living; what you need to get by with
daily rituals such as hygiene, breathing exercises and mobility. No stooping or
bending and no lifting over 2 pounds as any increased activites may generate
more swelling or bleeding. ADL’s for the first 3 weeks.

2.Exertion: starting to do more than what is required such as
exercise, sex or pulling and lifting suitcases. After 3 weeks.

In
general, I have found scar formation and tightening to the point of restrictive
movement and some skin irregularities for the first 3 months.
Different
and changing levels of massage as the healing process progresses such as:
1 gentle
pressure
2 gentle lymphatic
or “squeege” motion
3 firmer
lymphatic or “squeege” motion
4 “rock
and roll” or firm deep massage for lumpsOver doing massage creating the redness for example I see in your photos may create more inflammation and prolong swelling and scar formation with resultant banding. 


Emotionally,
patients go through a “roller coaster” of concerns and presentations. You can
expect:

1-5 days: initial surprise: “I didn’t expect this”

1-3 weeks: concern and a feeling of “did I do the right thing”

2-4 weeks: worry: “when is this swelling, bruising going to go
away”

4-12 weeks: more worry: “why am I forming lumps and
irregularities”

2-4 months: depression: “I have to look socially acceptable and
I look deformed”

3-4 months: sunlight: “it’s getting better”

6 months: elation: “wow, I look good”

9-12 months: super-elation: “wow, I look hot!”

3-10 years: eventual disappointment: “where did it all go?”

Each patient and each physician interpret their
changes and findings differently.

Return to
your treating physician and discuss what is best for you.
All the
best!

It appears that there was too much liposuction or some type of platysmaplasty was performed. You may benefit from steroid shots in the area to soften scar tissue and help reduce the mounds between the ridges. This can be repeated 3-4 times. After that you may need a scar revision but only after 6-9 months to allow the scar to soften.

This is a difficult problem to fix.  There are a number of potential causes, but without knowing what exactly was done during the surgery it is not possible to say what caused this or what the best option for improvement may be.  If they do not resolve, you may need revision surgery to try to improve the cords.  You should continue to address these concerns with your surgeon or seek a second opinion from an American Board of Plastic Surgery certified plastic surgeon.

this is clearly a distressing issue for you. However 13 weeks you are not fully recovered. Massage is a good idea and if things are not settled by about 9 to 12 months you may need a revision.

Dear Braxton06,  After reviewing your post operative photographs I certainly understand your concerns. You are still early in the recovery phase and I would continue discussing your concerns with your surgeon. You need to wait at least another 3 months for your healing to resolve and if the cording persists then revision surgery will be needed. A copy of your operative report would be helpful to fully understand what was done during your procedure. Best regards, Michael V. Elam, M.D.