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

Question

I have "pouches" on either side, under chin 6 monthes post neck lift w/platysma. My PS says the pouches are glands or muscle, but there is also a little loose skin and will do a revision under local anestesia in 3 weeks. I did not have any fat on my neck before surgery only a double chin, with NO POUCHES!My neck still feels so tight & I have a "keliod" scar under earlobe from necrosis that he says he will remove during revision. he also says there is not much skin to tighten. Will revision help?

Scott Trimas, MD · Answer

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.

Brian K. Machida, MD, FACS · Answer

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.

Sean Maguire, MD · Answer

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.

Darryl J. Blinski, MD · Answer

I have to ask was the surgeon a boarded Plastic Surgeon? Appears there are many issues that can only be explained in an IN PERSON evaluation.

Somyos Kunachak, MD - Account Suspended · Answer

Hi Kelise,Based from the photos you provided, the position and location of the "poches" look more like  hypertrophy of the digastric muscle and not the submaxillary gland. However, enlargement of this gland may aggravate the bulk on the posterior (back area) of the pouch. Personal evaluation will be needed to confirm this. In addition, you also seem to have some residual loose muscle and skin to be addressed as well.

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

Answers (5)

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

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

Answer: Post-op Necklift Result

Answer: Post-op Necklift Result

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

Answers (5)

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

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

Answer: Post-op Necklift Result

Answer: Post-op Necklift Result

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Recommended reading

Everything you need to know about Neck Lift

Our mission is to create a world where every investment in modern beauty is Worth It.