Neck & mini FL w Lipo? (Photo)

Question

58 yr/fm 125lbs fair/ normal skin tone. 7mo post procedure. Experiencing shock-like pains, hot skin to touch and a bunch of plastismal bands - Constant stinging pains. I shared these concerns with my Surgeon and he says I look good & all is normal. I however, do not like what I'm seeing in the mirrorr. My Surgeon did suggest injections (I'd have to pay) I explained the reason for paying for surgery was to avoid injections - this was discussed during my consult.. Ty!

Elie Ramly, MD · Answer

Thank you for your question and for sharing your photograph. At seven months after surgery, it is reasonable to seek re-evaluation for persistent concerns, particularly because you are describing both visible neck banding and ongoing shock-like/stinging pain.
Your photo does appear to show vertical bands and contour irregularity in the central neck. These could potentially be related to recurrent or residual platysmal and/or skin bands, scar contracture or tethering, or a combination of factors. A photograph alone cannot determine the underlying cause, and an in-person examination would be the appropriate next step.
The pain deserves separate attention. Intermittent burning, stinging, hypersensitivity, or electrical sensations can occur during sensory nerve recovery after facelift and neck lift surgery, but persistent or significant pain at seven months should be assessed in detail in person rather than simply assumed to be part of normal healing. An examination can help determine whether nerve irritation, scar-related discomfort, or another process may be contributing.
For the visible bands, treatment depends on the underlying anatomy. Injections can be helpful in selected cases&mdash;for example, steroid and/or 5-FU can sometimes be considered for problematic scar tissue, while neuromodulators such as Botox may help with dynamic platysmal banding. However, these treatments are not appropriate for every type of postoperative neck irregularity. If the problem is primarily structural or anatomical, surgical revision may ultimately be considered. You also mentioned liposuction, which could have resulted in thinning of the delicate subcutaneous fat layer and contributed to the appearance, especially with scarring developing in that layer.
In the absence of a reason to intervene sooner, allowing approximately at least a full year for healing, scar maturation, and the result to settle before considering revision surgery is reasonable.
I would not recommend deciding on injections or additional surgery based on this photograph alone. At seven months, an in-person evaluation&mdash;including examination of the neck at rest and with animation and review of what was performed during your original facelift/neck lift&mdash;would be the appropriate next step. If you remain concerned after discussing this with your surgeon, obtaining a second opinion from a plastic surgeon experienced in facelift, neck lift, and complex revision neck surgery would be reasonable.
The important distinction is determining whether you are seeing a dynamic platysmal problem, scar-related contour irregularity, skin banding, or another postoperative change, because each may require a different approach.

Neck & mini FL w Lipo? (Photo)

Answers (1)

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