I had a necklift with platysma 6 months ago. There are 2 "pouches" under my chin. Should I have a revision? (Photo)

It is possible that it may be some persistent skin, skin and muscle or skin, muscle and fat. From the limited views it does not appear to be your submandibular glands since it is too far toward the front of your neck. It may also be that too much fat was removed directly under the chin. In either case, it is not uncommon to require a revision in that area called a submentoplasty and often corrective procedures help that area. Good luck with your procedure.

I've seen this before in revisions from other surgeons. Revision is appropriate at this point. The swelling is due to how the platsyma reacted to different pulls from surgery. Wide skin elevation is recommended to visualize the muscle. Defatting of the area is recomended. Lateral muscle pull alone will not likely resolve the problem. It might also be due to thick muscle or fat under the muscle.  I would approach the muscle medially to see what's going on. There's no reason it couldn't be done under local. I do wide dissection all the time under local. Your doctor just has to be comfortable doing it that way. It seems reasonable that there may not be much skin to tighten.

In my opinion, based on your photos it appears you have at least a couple of issues here. First, it looks like there was liposuction done centrally under the chin and perhaps too much fat was removed. Second, it appears that the platysma was tightened or pulled laterally quite aggressively, giving an exaggerated acute angle to the neck. Then there is the issue of the sagging skin at the jaw line. Based on my experience, this is not what sagging submandibular glands look like. If you are not comfortable with your surgeon's approach you may want to consider a second opinion from a board certified plastic surgeon or facial plastic surgeon.