Will the puckering on the bottom edge of my platysma scar flatten out and what is the pocket to the left of my chin? (photos)

I had a platysmaplasty revision 11 days ago. At day 5 I was told to take down the dressing and the scar had not come together and had formed a wide scab. I contacted the CS and he was going overseas and I saw his partner the same day who sutured it together. I now have puckering on the underside of the scar. Will this flatten? I also have a pocket on left side of my chin. What is this and what can I do about it? I am very self conscious going back to work next week.

Doctor Answers 5

Platysmaplasty Neck Surgery

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It is a bit difficult to judge because after eleven days, you are not fully healed.  It does appear from your photos that you might have a non-union, and dimpling of the skin, from the type of closure that was employed by your surgeon. My best advice is to go back and see your surgeon. In my practice, I prefer to sew my platysmaplasties in many layers for support, and in the final layer, I sew with extremely thin subcuticular (under-the-skin) sutures under loupe magnification for the finest possible incision line. 

Puckering and swelling

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By now, I'm guessing most of the puckering has gone away. It should continue to improve. But looking at your 5 days post-op picture, it looked like there might have been a wound infection. Happily, the 11 day post-op picture looks much better. The pocket on the left is possibly swelling, but might be a bit of retained fat.  Swelling will go away, but retained fat might require a small revision.

Norman Leaf, MD
Beverly Hills Plastic Surgeon

Plastysma plasty - why is it puckered

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Thank you for asking about your platysmaplasty revision.

  • The puckering will probably subside in time -
  • You appear to be very swollen
  • This can be difficult to conceal but a little make up and perhaps a neck scarf may help.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Puckering Scar on Face -- Lasers, Microneedling/PRP, Subcision, Fillers, Dermaflage/ScarMD

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The appearance of this scar can be improved with lasers and microneedling/PRP. Sculptra with radiofrequency/ultrasound skin tightening (thermage or ultherapy) also softens this area. I recommend seeing an expert for a formal evaluation. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Neecklift recovery....

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Some patients look and feel great after two weeks from surgery, and others are bothered by lumps and bumps or changes in skin sensations for months after. The recovery from a facelift/necklift varies from patient to patient. 

No surgeon  can predict which patient will heal quickly and which patient won't, and this can be frustrating for both, patient and surgeon. You are experiencing what is commonly known as "poor wound healing" but it doesn't mean it is normal. Keep in touch with your surgeon and evaluate how the incisions look after a few months. If you aren't comfortable with the way they look, you may be able to discuss scar revision with your surgeon.

Have a great day!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.