Can a bad neck lift be fixed? ((photo)

Question

Seven years ago I had a SMAS mid/lower-facelift, which included a neck lift. Several months post-op I noticed that the left side had noticeable laxity. Upon seeing this, the surgeon shot lidocaine behind my left ear and removed a section of skin, pulling the rest straight-up and suturing it. Afterward the left side of my neck looked pulled and there were now noticeable wrinkles radiating from behind my left ear and covering the left side of my neck. Can anything be to fix this?

Timothy R. Miller, MD · Answer

Perhaps.An in-office examination is really needed to assess the skin (laxity, creases, etc.)  and the position of the previous incisions.  Often elevating the skin and re-draping the skin in a more favorable vector is all that is required.  But much depends on the issues mentioned above.I hope this helps.

Jed H. Horowitz, MD, FACS · Answer

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.

Ross A. Clevens, MD, FACS · Answer

As noted by the other doctors, a necklift may improve your areas of concern.  It is best to schedule a consultation with a board certified facial plastic surgeon to determine your best options.

Michael I. Echavez, MD · Answer

It may be possible to improve your issue of lines and wrinkles on the left side of your neck from your facelift 7 years ago.  You really would need to be examined to determine if you might be a candidate for a revision procedure or not.

Matthias Solomon, MD · Answer

From the photo, I see bunching up of skin at one point behind your ear giving the appearance you describe. Obviously a detailed in office exam is required; but this can be corrected fairly easily with a revision neck lift. If you have had additional neck changes and laxity develop since the initial procedure a full neck revision is required. If all you are seeking to correct is the wrinkles behind the ear, it can be corrected with less surgical dissection.

Toby Mayer, MD · Answer

Facelift revision for excess neck skin can improve the results but I need to examine the neck with head not turned etc. to give a proper answer.

Sean Maguire, MD · Answer

Thanks for your question and photos. The pleats on the left side of your neck could certainly be improved with a revision. If I was doing the revision I would utilize the existing scar behind the ear and in the hairline to redirect the skin pull to a more horizontal vector. Other than the pleating, your neck still looks pretty good!

Michael Law, MD · Answer

Lateral neck creases after face and necklift surgery can be a frustrating problem for patients. I’m sure it is especially frustrating for you as it is out of harmony with an otherwise youthful-appearing face. Sometimes these creases result from a less-than-ideal approach to skin redraping around the ear, but in some cases – primarily in patients who already have some lateral neck skin aging changes and associated laxity - they are difficult to avoid. They tend to be most prominent with the head turned to the side, as demonstrated by your photographs. Your jawline and anterior neck appear well-defined, so clearly the approach to this problem should not be another conventional face and necklift procedure, or some variation on that theme. The skin excess of your lateral neck is in parallel with the direction of the creases, and the ideal procedure for improving this issue for you would be skin excision in that local area that is designed in parallel with the creases. It should be designed as an ellipse that when closed produces a linear scar that is mostly or totally concealed by the collar of your dress shirt and your occipital scalp. There’s not much of a way around this. If you really dislike the creases, the skin excess has to be removed. Like many plastic surgery procedures, you are trading a cosmetic improvement for the scar or scars required to create the improvement. It’s a matter of deciding if the trade-off is worth it to you. Elliptical excision is a reasonable approach for most men as the neck skin is more ‘rugged’ in men – it’s thicker, more irregular and tends to have signs of photoaging which help to conceal the scar. It is also better concealed in men while healing as men tend to wear collared shirts, especially in social settings. Ultimately the scar should be minimally noticeable when not concealed by a shirt. And a scar in this position easily could also be from a skin cancer excision, a sebaceous cyst or lipoma excision, or an orthopedic surgery – so it is not obviously associated with a cosmetic surgical procedure. For women it’s  different story: the skin is thinner, usually less affected by photoaging (longer hairstyles tend to shade the area) and female clothing tends to leave this area widely exposed. So this solution is not as easily applied to female patients.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

Revision surgery is the only way to correct this issue. At seven years postop, you may be due for a revision anyway. Have your face and neck evaluated by a board certified facial plastic surgeon who specializes in these techniques.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and your question and, though an examination is really needed, it does appear that the appearance of your neck could be improved with further surgeryDr. Corbin

Can a bad neck lift be fixed? ((photo)

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