9 months after full face/neck lift platysmaplasty/lipo, doctor suggests digastric muscle resection/spot submental lipo. I'm 54 years old. Under chin looks tight down center with bulges on each side/loose skin. Bulges are not firm at all. I think he pulled the skin tight since the scars behind my ears and neck have widened and could feel tugging/pulling for first several months. Do you agree I need spot lipo and Anterior Digastric muscle resection? He says it’s a quick 20 min procedure. Is this safe? Will it solve the problem/loose skin? How to know for sure the problem is with those muscles? If it doesn’t work what’s next?
Answer: Submental tightening Thanks for your question. I think that a submental approach to your problem is likely to give the best results. However, I do not like the idea of resecting the digastric muscles. I think that a better improvement can be obtained by further tightening of the platysma muscles. I recommend a corset platysmaplasty with removal of excess lateral fat. I would be careful not to excise fat deep to the platysma muscle, which I think might exacerbate the problem.
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Answer: Submental tightening Thanks for your question. I think that a submental approach to your problem is likely to give the best results. However, I do not like the idea of resecting the digastric muscles. I think that a better improvement can be obtained by further tightening of the platysma muscles. I recommend a corset platysmaplasty with removal of excess lateral fat. I would be careful not to excise fat deep to the platysma muscle, which I think might exacerbate the problem.
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September 19, 2018
Answer: Anterior Digastric Surgery for Residiual Neck Laxity post Facelict Residual neck laxity with continued excess volume and platysmal relaxation can be addressed both surgically or non-surgically.1. Non surgical: In our practice, three technologies can help with residual neck laxity and volume excess. These include using neurotoxin (botox, xeomin, dysport) to weaken the platysma, Kybella injections to melt fat, and radiofrequency treatments to tighten skin and train the neck to sit in a better position. Most practices should be able to offer you some non surgical options to try.2. Surgical: While spot liposuction with laser technology OR digastric resection sounds like good options, in our experience the outcomes are very tenuous at best. The best options in these cases are to wait a year, find a qualified physician, and undergo some type of revision procedure to get a better pull, reset the platysma muscle and then more definitively address the excess volume.Hope this helps.
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September 19, 2018
Answer: Anterior Digastric Surgery for Residiual Neck Laxity post Facelict Residual neck laxity with continued excess volume and platysmal relaxation can be addressed both surgically or non-surgically.1. Non surgical: In our practice, three technologies can help with residual neck laxity and volume excess. These include using neurotoxin (botox, xeomin, dysport) to weaken the platysma, Kybella injections to melt fat, and radiofrequency treatments to tighten skin and train the neck to sit in a better position. Most practices should be able to offer you some non surgical options to try.2. Surgical: While spot liposuction with laser technology OR digastric resection sounds like good options, in our experience the outcomes are very tenuous at best. The best options in these cases are to wait a year, find a qualified physician, and undergo some type of revision procedure to get a better pull, reset the platysma muscle and then more definitively address the excess volume.Hope this helps.
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September 17, 2018
Answer: Digastric resection Further lipo may be of some benefit. I would probably do direct excision of excess fat through a submental incision. I would not perform resection of the anterior digastric. It is unlikely to do anything and places a nerve in the area at unreasonable injury risk.
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September 17, 2018
Answer: Digastric resection Further lipo may be of some benefit. I would probably do direct excision of excess fat through a submental incision. I would not perform resection of the anterior digastric. It is unlikely to do anything and places a nerve in the area at unreasonable injury risk.
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September 14, 2018
Answer: Anterior Digastric Muscle Resection Thank you for your question and the photos.Anterior digastric muscle resection is a safe operation and can improve the neck contour in the right individuals.The second question is the more difficult one to answer.Your surgeon is clearly willing to work with you and has the advantage of knowing your anatomy first hand. I do not believe large digastrics are the entire solution to your neck contour. There is more fullness in the neck than a large digastric will create. There is most likely remaining fat to be contoured as well as the possibility of large salivary glands in the area. Despite the widening incisions behind the ear the skin below the neck remains somewhat loose.Good luck and I hope this was helpful
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September 14, 2018
Answer: Anterior Digastric Muscle Resection Thank you for your question and the photos.Anterior digastric muscle resection is a safe operation and can improve the neck contour in the right individuals.The second question is the more difficult one to answer.Your surgeon is clearly willing to work with you and has the advantage of knowing your anatomy first hand. I do not believe large digastrics are the entire solution to your neck contour. There is more fullness in the neck than a large digastric will create. There is most likely remaining fat to be contoured as well as the possibility of large salivary glands in the area. Despite the widening incisions behind the ear the skin below the neck remains somewhat loose.Good luck and I hope this was helpful
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September 13, 2018
Answer: Neck fullness and bulges Excellent question, common problem, no quick answer, and NOT a 20 min procedure, at least in my hands. Those paramedian bulges may be due to fat beneath loose skin folds or uneven fat resection, "sub-platysmal" fat, contraction of platysmal bands even after platysmaplasty, bulky anterior bellies of digastric, submandibular glands, a combination of the above, or something else. Neck anatomy is complex, variable, and dynamic, i.e. changing with your position and often in motion. Only your surgeon knows exactly what was done, and he/she has a plan to improve it.
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September 13, 2018
Answer: Neck fullness and bulges Excellent question, common problem, no quick answer, and NOT a 20 min procedure, at least in my hands. Those paramedian bulges may be due to fat beneath loose skin folds or uneven fat resection, "sub-platysmal" fat, contraction of platysmal bands even after platysmaplasty, bulky anterior bellies of digastric, submandibular glands, a combination of the above, or something else. Neck anatomy is complex, variable, and dynamic, i.e. changing with your position and often in motion. Only your surgeon knows exactly what was done, and he/she has a plan to improve it.
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