Is a neck lift revision necessary to smooth out the lumps? (Photo)

Question

I had a lower facelift and platysmaplasty in July of 2022. I have given my body 15 months to heal but I’m not sure if I need more time. I have a lump in my neck (too high to be thyroid) and I am still a little bumpy/uneven under my chin along with a little divot. I asked my doctor about the lump, and he said I should speak to my primary care physician. Have you seen anything like this before with a neck lift? Is a revision necessary to smooth out the lumps? Thanks.

Zoran Potparic, MD · Answer

It is very difficult to comment on your result without preoperative photos and in-person evaluation. Lumps in the neck 15 months after surgery may be due to different reasons; visible submandibular glands, thyreoid cyst/mass, as well as residual fat tissue in the lower neck which is difficult to remove in the course of the neck lift. It would be in your best interest to eliminate thyroid issues first and consider a second opinion consultation with an expert in face/neck lifts. Hope this helps.

J. Timothy Katzen, MD, FACS · Answer

Thank you for sharing your concerns and photos. Addressing neck skin laxity and platysmal band prominence following a previous neck lift requires a carefully planned revision.
Revision Neck Lift: Your photos indicate neck skin laxity, which can be effectively addressed with a revision neck lift. The procedure would typically involve incisions around the ear to access and tighten the underlying structures, thereby improving the appearance of wrinkles.
Platysmal Band Management:
Platysmal Plication: This involves surgical modification of the platysma muscle through an incision under the chin, which can provide a more lasting solution.
Transection: Cutting the platysmal band is another surgical option, providing a more permanent correction.
Botox Injections: A non-surgical, but temporary solution, Botox can relax the platysmal band, reducing its prominence. However, this will require ongoing treatments as the effects wear off over time.
Considerations for Revision Surgery:
Duration: Given your history of a prior neck lift, the revision procedure might take between 3 to 5 hours under general anesthesia, possibly longer due to the complexities involved.
Recovery: Revision surgeries typically have a more prolonged recovery period, and the healing process might be more challenging due to the pre-existing scar tissue and adhesions.
Next Steps: A detailed consultation with your plastic surgeon is vital to discuss these options and tailor the approach to your specific needs and expectations.
Please feel free to reach out with any further questions or clarifications you might need. Your well-being and satisfaction with the results are of utmost importance.
Wishing you a successful outcome for your revision procedure.
Sincerely,
Dr. Katzen

Jacob Tower, MD · Answer

Hello, hope you are well. Thank you for submitting your question and photos. I think the most useful thing for you to do would be to have this examined in-person. A physical exam and more detailed history would go a long way in guiding you to resolution. It may be from scar tissue and unfavorable healing in which case some minimally invasive therapies could help. Alternatively, it may be an issue that requires revision surgery. Lumps are not all that uncommon immediately after surgery, but by 15 months postop, it is unlikely to resolve on its own.
Best,Dr. Tower

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