Is this a seroma and will skin reattach to tissue following neck lift/platysmaplasty and lipo? Can this be corrected? (photo)

Question

6 weeks post platysmaplasty/neck lift with lipo. PS had me wear chin strap for 1 wk then discontinue. As the swelling subsided some I noticed as softening began under chin that was bulging on left side and uneven. If I push lightly on it the bulge disappears but reappears. If I tilt to the right the bulge moves. The skin seems loose and soft. I am concerned as definite heaviness on one side and worried skin not attaching. Will skin reattach this late if it is fluid? Unhappy

Raymond E. Lee, MD · Answer

Good question.  It is hard to ascertain over photos.  It could be free fluid (seroma) versus swelling.  A seroma will look like the skin is floating over water.  This is really should be evaluated by your surgeon and a seroma can be removed with a needle.  If its swelling then warm compress would help but again your surgeon should guide you.

Jed H. Horowitz, MD, FACS · Answer

It's difficult to determine without knowing more about the surgical #techniques applied during your procedure and I can certainly understand your concern.It is not uncommon to be experiencing some #lumps four months post-op. Recovery from a neck and facelifts do vary per person. This process can take from 2-6 months for face, neck and cheeks. Muscle weakness may also be present around the mouth especially if liposuction is used. Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely. It is during this time that the rejuvenating effects of your procedure will become apparent and the real result will be seen. I always suggest to my patients, if they have any concerns during their healing to call me and discuss those #concerns. I encourage you do the same to your doctor. It is best you continue to be #evaluated in-person by your doctor to closely modify your progress and determine if additional care is necessary.

Mark Karolak, DO, FAOCO · Answer

Without examining you in person, it is difficult to give an accurate assessment of your neck. However, based on your description and pictures, it is very likely to be a seroma that is causing the swelling under your chin. It is important to see your surgeon to evaluate and treat this accordingly. It may need to be drained. Regular follow ups with your surgeon over the next year will be important to make sure that the cosmetic result is optimal.  Interventions may include compression, lymphatic massage, weekly ultrasound treatments, waiting for healing to complete, and, as a last resort, a smaller revision procedure.

Jason Emer, MD · Answer

It's difficult to tell from your picture. I recommend following up with your Doctor for a formal evaluation. It can take up to 6 months to have your final results with a neck lift. To improve your final results, I recommend a combination approach with thermage/venus legacy and Kybella/Ultherapy. I recommend getting a formal consultation with an expert. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

I would encourage you to see your surgeon for this and let the surgeon assess the issue and advise you.  Wearing the neck strap longer than a week is not reasonable.  This may just be persistent swelling rather than a persistent seroma.  If this is a seroma, it is small and yes, they do resolve on their own.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Unfortunately it is difficult to offer definite advice without an in-person examination but it does appear that you have greater fullness along one side of your neck over the other.  I would recommend seeing your surgeon to discuss your results in order to rule out a fluid collection, residual muscle laxity, or natural asymmetry due to the underlying musculature or salivary gland.  Based on the diagnosis the appropriate treatment recommendation can be made.

David A. Sieber, MD, FACS · Answer

Thank for the great question. It's difficult to appreciate the fluid from the photos along. I would go back to see your surgeon so that they are able to examine you in person. At only 6 weeks after surgery you may still have some residual swelling that lasts for another 1-2 months. The fullness in your neck could be do to a number of things. If there is a little fluid there then it's east to drain in the clinic and the skin should stick back down without any issues. Best of luck and congratulations on your surgery!~Dr. Sieber

Darryl J. Blinski, MD · Answer

Without being seen in person very hard to give accurate dx. Seek in person second opinions. I might try needle aspiration if I thought this was fluid. I also would recommend multiple ThermiSmooth 250 external RF sessions to neck, at least 10..

Val Lambros, MD, FACS (retired) · Answer

you need to be seen in person. The trouble with neck seromas is that when the fluid absorbs it leaves a lump of scar tissue that takes a long while to resolve and will need multiple treatments to make it better. Get it looked at.

Is this a seroma and will skin reattach to tissue following neck lift/platysmaplasty and lipo? Can this be corrected? (photo)

Answers (9)

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