Choking tight neck feeling after Face and Neck Lift - what could this be?

Thank you for sharing your story — what you’re describing sounds incredibly uncomfortable, and it’s clear you’ve been proactive in trying to understand what’s going on.
After undergoing a face and neck lift, some patients report a persistent tight, band-like sensation across the neck or under the jawline. When all structural and neurological evaluations (like ENT, MRI, and barium swallow) come back normal — as in your case — the most likely explanation is related to post-surgical soft tissue tension, scar contracture, or platysma muscle involvement.
You mentioned it feels like a tight band from ear to ear and even causes a choking sensation — this may indicate:
Over-tightening of the platysma muscle during surgery
Myofascial tightness or adhesions beneath the skin
Nerve hypersensitivity due to healing around the cervical branches of facial nerves
A rare paradoxical reaction to Botox (though uncommon, some people report increased tension or altered sensation post-injection)
The feeling that the Botox "hasn’t worn off" after 6 months is unusual — Botox typically wears off within 3–5 months. However, if the original tension wasn’t from overactive muscle, but instead from scar tissue, Botox may not have helped (and in some cases, if not injected precisely, may even alter the muscle balance and exacerbate the feeling).