How can a too tight neck lift be repaired?

Question

Along with the banding showing ear to ear under chin, I cannot adequately move my neck as there is terrible pulling underneath each jaw, as if there is not enough skin to allow me to look up or even turn side to side along with pain. I am 4 Months into recovery and don't feel I am getting adequate answers from my current PS and am quite frightened that this cannot be fixed. I also need correction on pixie ear

Tanveer Janjua, MD · Answer

The tightness continues to improve on its own.  Sometimes trying to fix the tightness can lead to more problems.You should wait for 1 whole year and at that point if you still feel the neck to be tight then you can undergo a revision which would include releasing some of the scar tissue under the chin area and the pixie ear deformity can be corrected at the same time.RegardsDr. J

Frank P. Fechner, MD · Answer

I would recommend to be patient and wait for muscle and skin to go through the final stages of healing. Many patients feel still a LITTLE tight after 4 months - and this feeling routinely subsides. That your range of head motion is limited is unusual. Still, tincture of time is your best friend at the moment. Pixie ear repair requires a separate procedure which is best done after 1 year.

Jason Emer, MD · Answer

You may still have some swelling that is inhibiting movement and will loosen with time. Steroids +/- 5FU may help to soften scars. The ear could be treated with long term sculptra or belafill, but I often do lasers / RF treatment with microneedling/prp and fillers for short term in this area. I recommend consulting your Dr again about your concerns and possible treatment options. Best, Dr. Emer

Jeffrey L. Schmidt, MD · Answer

Hi there, nycitygirl49. I'm sorry to hear that you are frightened by the results that you have 4 months into recovery. It's tough to know exactly what's going on without seeing any photographs, but the natural course following any facial rejuvenation surgery is a continuation of the aging process.  This means that you will most likely develop increasing skin and soft tissue laxity.  Over time, I suspect that this additional laxity will allow this component of the problem to take care of itself.

Fortunately, the pixie ear appearance that you mention is also something that can be addressed, but it will likely require the passage of a more time, as well. It may be too soon to perform a revision now, particularly if you are still very tight in the neck.This problem typically occurs when there is too much tension pulling across the scar, and that happens when things are pulled too tight relative to the support of the deeper soft tissue suspension sutures. You might consider talking to your plastic surgeon about whether Physical Therapy may be helpful to improve range of motion and pain.

Once there is enough tissue laxity in the neck area, you can then consider doing a revision procedure to address the pixie ears problem. I strongly encourage you to have a very candid conversation with your plastic surgeon if you haven't already to let her/him know that you'd to improve the communication.  Take care, and best wishes to you.

Benjamin C. Paul, MD · Answer

Thanks for your question. Over time, your neck will loosen and will likely settle down. In the meantime, there are things that can be done. You can ask your PS if it is appropriate to inject steroids or 5-FU which can soften scars. You can discuss exercises to improve your range of motion with your PS as well. If you feel like you are not getting answers, there may be benefit to seeking a consult with a different surgeon for a second opinion. Best of luck with your recovery

How can a too tight neck lift be repaired?

Answers (5)