Ropey band on jawline - is this cobra neck? (Photo)

Question

”5 months post deep plane facelift w/ platysmaplasty. This ropey band on the jawline appeared two weeks post op. Surgeon says it was bleeding when releasing the retaining ligaments. I’ve received 4 steroid with F5U injections. Surgeon will not do any more. There is a distinct line of demarcation on one cheek lateral aspect, surgeon says they are internal permanent sutures. Cobra neck? Will these resolve or what are tx options?

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for posting your photos and concerns. The first photo shows a central depression/hollowing between the anterior bellies of the digastric muscles. This is a cobra neck deformity. When the line of demarcation on the cheek occurs after the deep plane lift, it is from the suspension sutures as your surgeon said, and usually disappears as healing progresses and swelling dissipates. There are different ways of dealing with the cobra neck to re-establish a level contour. For example, revision submental neck surgery with digastric reduction and/or fat grafting. The cobra neck will not go away on its own, but the other issues have a good chance of resolving with some more time. If they don't after a year or more, I would consider revision facelift surgery.

Best,
Dr. Tower

Gianfranco Frojo, MD · Answer

I would recommend a revision face/neck. There is a cobra neck deformity in the neck. The band in the left lower face is likely a contour deformity in the SMAS created from the pull or a rent/tear in the SMAS when attempting to suspend the face. At this level it would be platysma muscle (which fuses into the lower face).

Ropey band on jawline - is this cobra neck? (Photo)

Answers (2)

Recommended reading

Everything you need to know about Facelift Revision

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

Ropey band on jawline - is this cobra neck? (Photo)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Facelift Revision

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