Concerned About Doctors Suggested Approach to Neck Lift Revision

3 month visit to the Dr today. He agreed to a revision & suggested that the appearance that I have is due to fat left under the skin. He wants to make an incision under my chin again & take out more fat(I had little to begin with)and stitch the incision. I'm concerned about his approach. I dont think this is fat but is extra skin and his idea at a solution may cause more of an issue. I think I need tightening with incisions in front and behind the ears.

Doctor Answers 16

Concerned About Doctors Suggested Approach to Neck Lift Revision

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Thank you for posting the photos. Yes, you are correct, too much skin left, not fat. Best to see more consultants. From MIAMI 

Facelift revision.

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It looks like this is not excess fat but excess skin. Therefore, more fat removal will make things worse. See another experienced facelift surgeon to discuss what results can be expected in a revision.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Revision neck lift approach questioned.

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I assume you had incisions around your ears as part of the initial procedure. At three months post-op, this is the absolute earliest I would even consider any kind of revision, regardless of approach. Things have just barely and not completely begun to soften and mature. So consider waiting, though I understand your concern given your result shown in the photos.

Though I don't have the benefit of direct examination, nor the actual hands-on with your neck anatomy in the operating room like your surgeon, I must say I agree with you rather than your surgeon. There is little or no fat in the neck area, but perhaps this is your doctor's way of describing what will actually be lifting and re-healing the neck skin in a more smooth fashion. Redraping the skin is what is needed, and whether or not this can be accomplished through the small neck incision is the question. But redoing the entire necklift incisions around both ears requires significantly more time, suturing, and cost, and this needs to be taken into account as well.

You and your surgeon need to have a heart-to-heart talk and lay out the concerns, pros and cons, cost and risks, and arrive at a plan that makes you both comfortable. It sounds as if you both want a better result--so why not give that discussion a go?

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Revision of loose neck

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In my opinion, you are correct in that you have extra skin and not fat.  This would benefit much more from a facelift and not further neck fat removal.

Extra skin or fat after neck lift

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You should ideally see another surgeon who is experienced with neck lifts to examine you rather than stating what you need by examining a photo.  You may need to be evaluated with changing your head position to see what vectors of tension are needed to change the skin's tightness if it is loose skin.  The initial surgery and its skin incision should be evaluated to see in which direction your skin was pulled.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Neck issue

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Without seeing you in person it is difficult to say, but it looks like in the photos that it is skin.  Was the hairline incision used or a short scar.  It looks as if the skin needs to be redraped in a more posterior rather than vertical direction.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Face Lift, Beverly Hills Face Lift, Local Face Lift, Radiesse, perlane, Cheek Implants

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You should wait at least another 3 months for a total of 6 months in order for the neck skin to have had ample time to properly heal before a revision Neck Lift is considered IMHO.  From your photos, it appears that there is excess skin that would most likely require the incisions under the chin and behind the ear/into hairline, which is a formal Neck Lift

It's also likely that an incision would need to be created around the lower half of your ears to remove the excess skin created by the Neck Lift re-drape of skin in the upward and backward fashion.  This should be explained and demonstrated to you by the plastic and cosmetic surgeon that ypu choose to do the revision Neck Lift and partial Face Lift.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Concerned About Doctors Suggested Approach to Neck Lift Revision

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You may benefit from additional surgery to better correct your concern. Selecting your surgeon for a #revision is a personal preference. It's usually best to wait 6 to 12 months depending on the reason for #revision and you see a board-certified plastic surgeon who is highly experienced with the type of cosmetic surgery you are seeking. It is important to discuss your concerns at length with your surgeon as well. As with all #cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical #procedure and #revision, there are some risks of unhappy outcome or other complications which your surgeon should discuss with you. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Excess skin

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This does appear to be more of an issue with excess skin rather than extra fat.  The vector of the skin pull and excision may need to be addressed.  It would not hurt if you could wait longer for things to soften and settle to get a better result.

Revision neck lift

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Seems to me that the problem you have is extra skin. Removing more fat may aggravate the issue.
You may need a lower facelift with skin removal.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

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.