Based on the submitted photos it appears you have a result that falls within the expected range. Some of the contour irregularities are likely related to the 'pull' from surgery and ultimately settle out with additional time and healing. I always forewarn my patients that complete healing takes at least 12 months (sometimes longer, depending upon skin type and surgical procedure). I would recommend patience. When email fails, always give a phone call .. it would be very uncommon for a patient not to be able to get a hold of their doctor via email, phone, or answering service for the office.
As others have mentioned, it is unfair for me to judge some aspects of your result with your neck twisted in certain ways. Even unoperated necks will form some ripples and bands when the head is turned 90°. So, it would be important to see a standardized set of photos taken by someone else from all views to fully judge the result. Obviously, it's probably a better idea just to get evaluated in-person either by your original surgeon or by a local plastic surgeon.
That said, the bands in the central part of your neck appear to be residual platysmal banding. This is the edge of the sheetlike muscle that forms on each side of the neck. If this is the case, the only options to improve this are recurrent Botox to soften it, or surgery to eliminate it. I think the first step for you needs to be getting evaluated in-person by your surgeon. If this is not possible, look locally.
Best of luck!
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA
Some of your photos you are looking down and with your neck a little twisted. Photos with your neck on a neutral position are important. It does appear that you might have some platysmal banding still present on your bottom neck views. Without an in person physical exam it is very difficult to evaluate your concerns. Please communicate directly with your surgeon. If he still does not communicate, then look for a second opinion.
Hope this helps,
Dr. Gus Diaz
Very sorry to hear your post op facelift course has been so difficult.
It is difficult without a full exam to see exactly what is going on or to make a diagnosis.
That said, it does take a full year for things to settle down. Areas that are particularly thick and tight can be injected with 5-FU or steroids to soften. Scars can also be improved with scar fading creams and injections.
Tight bands in the neck can soften with time. In addition, while face and neck surgery can improve bands, it is difficult to make them completely go away.
If after a year some or all of these issues persist, you may need to consider revision surgery.
I would recommend staying in close contact with your surgeon and letting them know your concerns.
If you become dissatisfied with his answers or the results, seek out a second opinion form a facial plastic surgeon who performs face and neck lifts on a regular basis.
Dear Tribly, It appears from the photographs that you have bunching behind the ear and this is typically caused by the directional pull of the facelift. It is very important to drape the skin in a natural direction in facelift surgery and not to put to much tension on the skin by addressing the underlying muscle and tissues. As far as your neck you appear to have either had over aggressive liposuction in this area or the platysmal bands were sewn together ineffectively. If these do not resolve themselves over the coming months you will probably require revision surgery. Best regards, Michael V. Elam, M.D.
It looks like the neck was oversculpted (liposuction was too aggressive). The result of overpulling in a direction behind your ear (backwards) rather than in front (vertical direction) explains a lot of the issues you are having in the neck and chin area. Most likely things will not improve and you will require revision surgery to correct the problems you are noticing.
Your complaints are visible on the photographs. After 6.5 months I would not expect significant changes in these areas. I recommend moving forward and fixing the things that bother you. If you like your original physician, I would call his office and make sure they have been receiving your emails. I would ask the doctor to call you back. If you are not successful, l would move on and find a good board certified surgeon closer to you. It never hurts to get a second opinion. You will most likely need revisional surgery to correct these areas. Keep positive, because what I see is all "fixable".
Based on your photos there are some tightness of platysma bands that create the choking feeling. You need to see your doctor for close observation and possible botox injection to the bands in order to loosen the bands. Time will improve this.
I Trilby, it is difficult to say exactly what you need from the pictures that you have provided. Occasionally, the platysma muscle can separate several months after a neck lift procedure. This can be corrected by doing a revision procedure to re-tighten the platysma muscle. The tightness will gradually reslax however it could take several more months. Make sure to follow up with your surgeon to ensure that you are healing normally.
You might have some settling of the skin or a contracture. Check with your plastic surgeon to see what can be done like massage or steroids.