Thank you for reaching out with your concern about the tightness in your neck five years after undergoing a neck procedure. It's crucial to address any discomfort or unusual sensations that persist long after surgery. Based on your description of a noose-like or strangulation feeling, it's advisable to consult with the plastic surgeon who performed your original procedure. In many neck lift surgeries, a technique known as platysmaplasty is employed. This involves suturing the neck muscles, often with permanent sutures, from the chin to the top of the thyroid cartilage to create a more defined neck contour. It's possible that the tightness you're experiencing could be related to these sutures being overly tight. Your surgeon can assess if this is the case and whether the permanent sutures used during your platysmaplasty are contributing to the sensation you're experiencing. If it is determined that the sutures are too tight, your surgeon might recommend a procedure to release these sutures. While this could potentially alter the aesthetic results of your initial neck lift slightly, it may significantly relieve the feeling of tightness and discomfort. It's important to have a thorough evaluation by your surgeon to determine the best course of action. They can provide personalized advice and treatment options based on your specific situation and surgical history. I hope this guidance is helpful and wish you the best in resolving this issue. Sincerely, Dr. Katzen