Thank you for sharing your question and photographs. 'This requires complex revision surgery to correct. It appears that you have some persistent platysmal banding and some soft tissue/contour irregularities in the neck. What would be required to fix this is a deep plane facelift and deep neck lift. Unfortunately, This does most often require a complete revision, including the facelift. A neck revision alone is unlikely to completely fix the problems because there is so much residual redundant soft tissue and muscle in the neck, it would create a wave of soft tissue and skin as the neck muscles are tightened. Additionally, a platysmaplasty would be required to eliminate or improve the medial platysma bands. There is soft tissue irregularity in the area of the submandibular gland, which is worse on the left. This may need to be addressed with either partial or subtotal submandibular gland removal. The right side may need to be addressed, as well. Although, this amount of deficiency may require fat transfer. This requires a complex revision surgical procedure and a simple "nip tuck" wouldn't be sufficient, unfortunately. The good news is that there are many of us that perform these types of revisions (frequently) and there are good surgeons that can help. Make sure you consult with a board certified facial plastic surgeon with extensive experience in deep plane facelift and deep neck lift procedures. Good luck! Dr. Harmych
