4 months post face and neck lift, my neck is coming apart. There was no incision under chin. What can be done? (Photo)

Thank you for your pictures.  To be honest with you, at this time it is too early to do anything.  by 3 months you are 80% through the healing process - the last 20% can take another 9 months! Before doing anything you really want to ensure everything has totally healed - and then some.  As such, it is important to give it time before examining and determining whether anything has to be done.  That being said, if there is an issue lingering once you are healed, it can be fixed.  Do not worry.For now, what you can do to help break up some of the swelling and irregularities is light massage 3 times a day starting in the middle (close to the midpoint of the chin) and extending out towards your ears.  make sure your skin is lubricated with either vitamin E or a moisturizer so there are no traction injuries.  Hang in there.  The recovery process can sometimes be tough.  But you will get through it and should there be a need to tweek anything, it certainly can be done.  Best of luck.  

I’m sorry that you're disappointed in the results of your facelift. You need to schedule an appointment with your plastic surgeon, because only he or she knows the specific details of your case and the technique used. I can offer some possible reasons for the appearance of your neck, but without knowing exactly what your surgeon did and without an in-person evaluation, please understand that it is only educated speculation. It's possible that residual fluid pooled in the neck, as others have mentioned. Other possibilities include fatty tissue that your surgeon may not have removed, sagging submandibular glands, or simply loose skin or muscle that was left unaddressed in your procedure. Revision surgery may be needed, but I suggest waiting a few more months to see if these issues resolve on their own. You'll need to wait a bit longer before it's safe to move forward with additional surgery anyway. Good luck.

Thank you for the question and the photos. At 4 months, a lot of the healing has occurred -- but you may not be completely done. Generally, I recommend waiting until about 6 months before considering any kind of revision or tweak. From the photos, it looks like you may need some submental work -- liposuction for the residual fat and a platysmaplasty for the bands. Depending on how much skin excess remains afterward, this may need to be removed behind the ears. For now, however, please follow up closely with your surgeon. If he won't see you, please visit a board certified surgeon for a second opinion.

Thanks for the question, I always find that as you heal, the fluid follows gravity. The neck, particularly under the chin often holds the fluid the longest and can stay swollen for some time. After the fluid goes away, there can be irregularities that are temporary, but it is impossible at this point based on your images to know this. Its best to see your surgeon and follow the instructions. Rushing into a new surgery is likely not ideal untill a good amount of time has past. Hopefully things will improve, Dr James Bonaparte

I would certainly go back to your surgeon as your first step.  It looks like you have irregularities due to either delayed resolution of a fluid collection underneath your neck with residual scarring underneath the skin, or irregularities due to liposuction.  In either case, irregularities can sometimes be improved with steroid injections, and/or massage, and fat grafting once the tissues are soft. If your issues do not resolve over the next several months...and it is quite possible they will not, then a revision to the neck lift would  be indicated once the tissues are soft.  Usually I would recommend waiting 12 months.

Dear Leisa1Thank you for your question and photos!  There is healing that takes place for 6 months up to a year and a half.  Please follow up with your surgeon.With Warm RegardsTrevor M Born MD

You should wait two months before considering surgical revision. Conservative measures may help. If not, there may be adhesions in the middle and excess tissue on each side which could be scar tissue, organized fluid, or muscle redundancy resulting from the vector pulls used in your lift. It appears that you might have had some work done through a midline incision but your doctor would be the best person to answer that question.

Dear Leisa1,





It is difficult to tell with just seeing your pictures, but I agree that conservative measures should be employed for another two months before considering revisional surgery. It looks to me like you have persistent swelling there and a very dilute concentration of steroid can be injected into that subcutaneous fat to help with the swelling as well as vigorous massage to try to get this to redrape. If by six months, however, it has not improved then I would advocate you have a revision.





I hope this has been helpful.





Robert D. Wilcox, MD

the irregularities under your chin look as if the skin didnt heal smoothly and you have develope scar attachements between the skin and underlying tissues that are creating that irregular lookyou could wait a littleonger, perhaps a total of 6 months from surgery, but ultimately, I think that scar tissue will need to be surgcially releasedbest of luck

Looks as if some liposuction may have been done as part of the procedure and there is some irregularity in the fat removal.  This has just presented itself because the surrounding expected post op swelling has subsided.  You should probably give it another 2-3 months but if you are still concerned then I would likely talk with your surgeon about revision liposuction.