Can You Give Me Advice on my Surgery Outcome?

I am 53 years old and had a neck-lift 2 months ago. I am very disappointed with the results. I feel there is too much skin left and I have what appear to be flaps beneath my jaw line on each side of my face. I would consider revision surgery, but I developed a scar tissue where the drainage tubes were and elsewhere. This is currently being treated with ultra sound at the surgeons office. Would correction involve the same lenghty surgery?(2 hrs). Is there any other alternative other than surgery?

Doctor Answers 11

Neck lift or liposuction or platysmaplasty

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It is not easy to understand from your photographs what procedure was exactly done. With the incision one would imagine you at least had a platysmaplasty in which the neck muscle bands were tightened together but did you also have much fat before the procedure and have liposuction through that incision and did this account for loose skin? After your skin responds to time and the ultrasound you should consider a consultation with a plastic surgeon whose forte is necklifts.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Neck revision

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You more than likely will need a revision but I would give it a full 6 months or longer to settle down. It would also be helpful to know what exactly was done.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Unexpected outcome from necklift is a difficult problem

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I can see by your photographs your concern with your result. This unfortunately is a difficult problem. If you are already 2 months out from your procedure, then I doubt that your result will improve much from this point forward. I agree with the use of ultrasound to try to improve the tightness across the area under your chin. I would also consider injecting any firm bands of tissue with a dilute steroid solution. Ultimately, you will most likely be best treated with a revision surgery, with particular attention placed to the tissue under the chin. You may also get some improvement, but not resolution of the problem, with Ultherapy, an ultrasound based treatment that can tighten tissue. This is not the same as a normal ultrasound treatment, and is not as significant as surgery, but it may help.
Andrew C. Campbell, M.D.
Board Certified Facial Plastic Surgeon

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

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Do I need a neck lift revision?

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It appears that you sub-optimal re-draping results in the area under the chin. This is a frustrating problem. Steroid injection may help to soften some of the scar tissue under the chin and Ultherapy may be an option as well. Two months is still relatively early in the healing process so I wouldn't give up on the results yet. That being said, a revision is always an option but I recommend waiting at least six months before attempting a revision.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon

Neck skin redrape

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This may resolve over time with steroids/ultrasound/ massage. If not, you may need another procedure to re drape you skin. Ask your PS about the options and be patient.

Neck Lifting Results?

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Thank you for the question and pictures.

Unfortunately, your results are unsatisfactory and your disappointment quite understandable.

I would suggest waiting at least 9 months to one year after surgery to allow for “softening up” of the neck tissues;  I would also suggest consultation with a few well experienced board-certified plastic surgeons in person. Revisionary surgery will likely  require undermining of the irregular skin and redraping of this skin.

Best wishes.


Pleats in skin after face and neck lift

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 The pictures show skin pleats under the neck and jawline which typically indicate a smaller incision was used in the posterior scalp area.  This causes bunching, or pleats to form in the skin as a wider neck skin area is trimmed through a smaller posterior incision.  

 Yes, resoultion would require a revision formal Neck Lift that typically takes 3 hours or more.  Attention needs to be paid, IMHO to the laxity of the jowl area as well in order to prevent a similar occurrence in front of the ear.  The anterior section, of the ear, may have to be opened to allow proper skin redrape above the jawline.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Neck lift problem

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Dear Toadsmom - thanks for your question and the pictures - from the photos I see only a few issues that will correct with time - it is likely that a revision procedure with a redraping of skin will be necessary.  I have concern that the majority of the subcutaneous fat has been removed from under the chin area here which has resulted in scarring of the skin to the underlying muscle.  This will rarely ever look natural without a revision.  Time will elicit some improvement as will massage but after 6 months a consideration for a revision procedure should be made.  It would appear that the neck was the only structure addressed and it is my opinion that the face and neck are a contiguous unit - performing an upper or mid face lift has better success than just a neck lift - which I stay away from in my practice as a rule. Happy to help!

Paul E. Kelly, MD
Hamptons Facial Plastic Surgeon

Excess skin under chin after necklift

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Your skin "drape" under your chin is poor. This can happen from irregular skin drape during surgery, or from fluid collection after surgery distorting the lay of the skin.

Your best bet is revision necklifting to re-redrape the skin.  i would wait at least 4-6 months after your initial surgery to allow tissues to soften prior to revision to allow best results.

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 230 reviews

Revision face and neck lift works.

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Unfortunately, you have a poor result that will require revision. But I would wait at least another two months.

This is not easy to treat and I would avoid any minimalist solution, because you will be disappointed again. The excess skin needs to be re-draped upward and backward, and this is best done usually with a face lift approach. The incision is inside the ear in the front, and then behind the ear.  With skillful surgery, the scars are really inconspicuous.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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