Face and neck lift - is it possible the muscle was damaged or cut too short?

Question

I had a lower face and neck lift 5 years ago. I have severe tightness in my lower cheek, jaw and upper neck I have been to many doctors, plastic surgeons, neurosurgeons, and peripheal nerve specialist. The doctors thought I had peripheal nerve damge at firs,t but now that has been ruled out, I did have permanet sutures that I had removed over a year ago, but still tightness! It feels like a vise in the antetior triangle area of my neck. Is it possible the muscle was damaged, or cut to short?

Samuel Lin, MD, FACS · Answer

Thank you for your question. Generally, scarring can be a cause of neck tightness after surgery.. Regarding the treatment of the muscle it would depend on what procedures were performed and I would advise patients to check with your physicians about continued scar treatment, possible physical therapy to the area..

J. Timothy Katzen, MD, FACS · Answer

Hi Karencraft,

Thank you for your question regarding whether it’s possible the muscle was damaged or cut too short during a face and neck lift surgery. I appreciate your detailed history. I assume your question pertains to the neck muscle, specifically the platysma muscle. When plastic surgeons perform face lifts and neck lifts, they usually mobilize the platysma muscle and suture it together with a permanent suture to achieve a 90° chiseled neckline. Typically, plastic surgeons use permanent sutures. Generally, these permanent sutures don't pose issues. However, in your situation, these neck sutures had to be removed; sadly, their removal didn’t alleviate your concerns. It's highly improbable that the platysma muscle sustained damage. It's also unlikely that the muscle was truncated too severely. When performing a neck lift, most plastic surgeons avoid cutting or resecting the platysma, though there are exceptions. Given that the suture has been removed and you continue to experience discomfort, I'd recommend a consultation with a peripheral nerve specialist. You might be dealing with nerve entrapment, reflex sympathetic dystrophy, or complex regional nerve syndrome. These conditions are genuine and necessitate proper care. Thank you for bringing forward your concerns regarding potential muscle damage or alteration during your face and neck lift procedure.

Sincerely,
Dr. Katzen

Matt Novak, MD · Answer

While I can't provide a definitive answer, there are a few possibilities to consider:
Muscle or Tissue Damage: It's possible that during your lower face and neck lift, there may have been unintended damage to muscles or tissues in the area. This could potentially result in the tightness and discomfort you're experiencing.
Scarring: Scar tissue formation after surgery is common and can sometimes lead to sensations of tightness or discomfort. This could persist even after suture removal.
Nerve Irritation: Although you mentioned that peripheral nerve damage has been ruled out, it's still worth considering the possibility of nerve irritation or entrapment in the area, which can sometimes be challenging to diagnose.
Surgical Technique: The surgical technique used during your initial procedure could play a role. It's possible that the procedure didn't fully address your specific concerns or that there were complications during surgery.
Follow-up Procedures: In some cases, additional procedures may be needed to address persistent issues or complications from previous surgeries.
To get a more accurate assessment and potential solutions, I strongly recommend consulting with a trusted plastic surgeon or specialist who can thoroughly evaluate your condition, possibly with the aid of imaging studies or diagnostic tests. They can then provide you with a personalized treatment plan tailored to your specific needs and concerns.

Face and neck lift - is it possible the muscle was damaged or cut too short?

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Face and neck lift - is it possible the muscle was damaged or cut too short?

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