It has now been 4 months since I had my neck/face lift. My surgeon is board certified and only works on face and neck.He has been telling me that this puffiness will go away but I am getting ready to go back for a check up and I am just a little more than concerned about this now. I need to know if there is something further that can be done to make this look better or is this it? I am embarrassed to wear my hair back. Thanks for any insight you can give me about this.
Should I Be Concerned That my Neck and Chin Still Look Like This? (photo)
Doctor Answers 15
Conservative Measures First
Looking at your pictures, my inference is that your surgeon performed submental liposuction followed by some form of plication procedure for the platysma. While it is always a tricky business to try to make a diagnosis based solely on pictures, my guess is that the fullness you see is caused by a combination of factors.
At four months post-op, there is probably still a significant component of swelling and inflammation present in your neck. There may also be some residual subcutaneous and subplatysmal fat augmenting the appearance of fullness there. Finally, liposuction in this area frequently causes bands of scar tissue to form, some of which can cause tethering of the deeper layers of the skin to the now exposed platysma.
At four months post-op, you would be well advised to treat this conservatively with massage, and perhaps a couple of injections of dilute steroid at one month intervals. If there is still no improvement by the time six months have passed since your operation, it would be reasonable to begin to discuss other options with your surgeon.
Face and necklift swelling several months post op should be evaluated by your surgeon
Without knowing the details of your facelift procedure - I'd venture to say that you have some edema of the dependant tissues of the submental region. In patients with fatty necks, this can take a long time to resolve. You also have some contour irregularities here as well. Your surgeon will likely tell you this will take months to resolve, and I would second this advice. Certainly stay in touch with your surgeon in case you do need a revision months from now.
Excessive Submental Scarring
It appears you have build up of scar tissue below your submental incision. This can be a troublesome area especially if there is a postop collection of fluid or blood. The good news is that these areas almost uniformly improve with time. The bad news is that more than one surgeon has fallen in the trap of trying to improve this too early at the insistence of an unhappy patient only to make things worse. Be patient and trust your surgeon.
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I certainly see what you are referring to. At 4 months, I would consider this a less than ideal result. You certainly do have some residual swelling from your surgery, but that doesn't explain all of the contour irregularities present. You should discuss this with your surgeon. I would suggest waiting until at least 6 months after your surgery before considering revision work. It would be reasonable for your surgeon to want you to wait up to a year.
Asif Pirani, MD, FRCS(C)
Should I be concerned about my neck?
As others have commented it's hard to say without seeing your before pictures. You do appear to still have a lot of edema which should go away with time. You also have some telangiactasias which I have sometimes seen after extensive lifting and defatting of the skin. These occur while the circulation is being reestablished and can take a year to improve. They sometimes require laser treatment, but I would not recommend it before a year.
Fullness in neck 4 months after face and neck lift
It would help to see preoperative pictures for comparison, but here are some general principles. Some people take a little longer for swelling to resolve after surgery. Since the neck is the lowest point when compared to other facial structure, swelling often settles there due to the effect of gravity. Massage in an outward direction can help. Sometimes even a chin support worn in the evening can be of use, even at this late date If you tend to retain fluid with high salt intake, it would be wise to reduce salt in your diet. The key is the physical exam, and your surgeon is in the best position to help you. I would not recommend surgery yet, since time may produce further improvement.
Residual lumpiness of neck after lifting
It's hard to comment without before photo for comparison. It appears you do have some lumpiness and contour irregularity of the neck. It's important to discern if the contour is residual fat, scarring, loose skin or a combination of the above. The revision is based on what's causing it. I would still recommend waiting a bit longer before doing anything invasive or surgical. Massage therapy may help but discuss it with your surgeon first.
Stewart Wang, MD FACS, Wang Plastic Surgery
Face and neck lift are typically well healed by this time
I would address the concerns that you have with your surgeon. In some patients, with regard to any residual inflammation, there can be mild swelling that persists for up to 6 months. But as in your case, by 4 months, the lumpiness should be going down. You can massage the area to help it go down. But, I would definitely bring it up with your surgeon about your concerns and formulate a plan to address it.
Neck concern after facelift.
You should wait longer and follow up with your surgeon. I have been doing facelifts for 35 years and have seen this go away with more time.
Lumpiness after a Facelift
I can see the lumpiness on the photos. You have not posted your before surgery photos, but generally, after 4 months any lumpiness should be gone. Sometimes you will see slight "resagging" of the skin at 4 months. I don't think that is what is going on. I would speak to your surgeon and come up with a plan to address this. If you are not totally comfortable it is sometimes helpful to seek a second opinion.
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