Failed neck lift, is it Cobra neck & what can I do to fix this? (Photos)

Question

I am 51 years old and a deep plane face and neck lift in 03/23. I had significant neck laxity and jowling due to massive weight loss. The turkey neck is gone, but I’ve been left with a mess on my neck. My surgeon claims it can be fixed with Forma and coolPeel. I went for a 2nd opinion and the surgeon said there were discrepancies in the operative report and he was reluctant to do any revision for fear of nerve damage. What can I do to fix this? And is it “cobra neck”?

Gianfranco Frojo, MD · Answer

I would recommend a secondary facelift/necklift. It certainly looks like a cobra neck deformity. The other surgeon's concern about a potential nerve injury is not misplaced; revision facelift/necklifts do have a higher incidence of facial nerve injury compared to primary facelifts. This is because of the violated dissection planes, potential scarring, and the second surgeon often has no idea what the first surgeon did in the actual procedure. A surgeon comfortable with doing a revision/secondary facelift I would fine a surgeon certified by the American Board of Plastic Surgery; ideally one with also a 1 year aesthetic fellowship that has been accredited by the Aesthetic Society.

Jacob Tower, MD · Answer

Hello, hope you are well. I'm sorry to hear about your poor experience, but thank you for submitting your questions and photos. Unfortunately, the photos are insufficient to give a wholly informed response. Nevertheless, I do not believe that coolPeel or any RF/energy-based device like Forma will address the contour irregularity of your neck. If you're unsure, ask to see an example of a case such as yours where that approach was successful. A surgical revision is likely your best option, but additional standard views of your neck and face would be needed to render a more detailed opinion. 
Best,Dr. Tower

Michele A. Shermak, MD · Answer

Hello!
It is hard to tell what is going on from the photos. Do you have banding in your neck?
Your surgery was only about 6 months ago. Revision should wait for at least another 6 months. In the meantime it is important to optimize your scarring with topical therapies on the scars that include silicone and massage. If your surgeon offers microneedling this might help with scarring around the ear. 
I would not recommend noninvasive technology that may worsen scarring and cost more money. Surgery is likely your best remedy. The scars around the ears can be revised, the skin redraped and the neck improved with platysmal approximation - if that is what I am seeing in your photos. I would recommend you see an experienced board certified plastic surgeon in consultation.  The scars around the ears can be revised, the skin redraped and the neck improved with platysmal approximation. You can find one at plasticsurgery.org.

Darryl J. Blinski, MD · Answer

The posted photos are not descriptive. Need better full face posted photos in order to recommend revision surgeries. Appears severe sub mental dissection with residual hanging tissue, Was a neck lift done???? BEST to virtual consultations with......

Failed neck lift, is it Cobra neck & what can I do to fix this? (Photos)

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