Adam's apple and "cobra neck" after deep plane FL and NL? (Photo)

Question

6 months post deep plane facelift and neck lift. Great job getting rid of my jowls and turkey neck, but it's like the cartilage structure in my throat has dropped and relaxed. I understand that removing excess skin and fat make the neck structure more visible, but I've compared pics and my throat was not nearly this prominent. Can this be remedied w/under chin incision alone Does the cobra neck cause the adam's apple to press down and out? I'm 60, trying to be reasonable.

Jeffrey M. Darrow, MD · Answer

Thank you for your photo. It does not appear that the media bands of your platysma muscle were sutured together to create a uniform muscle layer across your entire neck. It would be important to know from your operative report whether any subplatysmal fat was removed or not. However, the bands of your platysma could be suture together through an incision beneath your chin and it should help to improve your neck contour in that area. Best wishes.

Gianfranco Frojo, MD · Answer

This is a cobra neck deformity with also some excess loose skin overlying it. The solution is revisionary neck-lift surgery. I would recommend a complete revision facelift/necklift as the extra skin must be pulled into the face and/or around the ears.

Jeffrey H. Spiegel, MD · Answer

Too much fat was removed in the center of the neck. That has led to hollowing and this cobra neck plus the overly visible Adam's apple.  We can address this with redraping the skin, restoring fat, and possibly reducing the Adam's apple.

Gregory S. Keller, MD, FACS · Answer

You have a lack of deep submental, fat and prominent digastric muscles, which are causing your cobra. This is Also causing your thyroid Cartilage(Adams Apple) To show. It may be necessary to either augment fat or pull a flap of fat up into the area and to either trim or reset your digastric muscles.

Thanapoom Boonipat, MD · Answer

Looks like they might be a bit aggressive with the fat removal in the midline. I agreed, this makes your throat area more prominent. I would ask if they can address this. This is difficult, but attempts at fat grafting the hollowness above it might make the throat area you don't like appear less prominent.

Adam's apple and "cobra neck" after deep plane FL and NL? (Photo)

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