Need advice on how to correct deformity caused by deep neck lift. I feel more insecure now than I did before (Photo)

Question

36 yr old female. 5'5" about 155 lbs. 2 years ago: deep neck lift, liposuction and microliposuction of the jowls. 6 months later: revision due to early recurrance of platysmal banding. After this "pouches" of skin on both sides of incision as well as 2 prominent bands were visible. 2 month later: "bilateral v to v setback" did not help only made scar longer. Injections of k10 and FLUOROURACIL were given but wore off and was told they would no longer help

Elie Ramly, MD · Answer

Thank you for your question and for sharing your photos. I can understand why the persistent contour changes would be frustrating, particularly after undergoing both a deep neck lift and a revision.
Your photos seem to show contour irregularity beneath the chin and along the upper neck, including visible linear bands and areas of skin and soft-tissue irregularity. However, photographs alone cannot establish exactly which anatomical structures are responsible, and I would recommend a physical exam as the best next step.
After previous neck lift surgery, this type of appearance can potentially result from several factors, including recurrent or residual platysma muscle banding, scar tissue and adhesions, skin or soft-tissue tethering, irregularities in the superficial or deep fat layer, volume deficiency, or altered relationships between the skin, platysma, and deeper neck structures. Previous surgery can make distinguishing among these causes more complex without a detailed exam. Obtaining your prior operative reports would be helpful as well.
Depending on the findings, treatment would potentially involve a formal revision face and neck lift procedure, which would include careful release of scar tissue or adhesions, aesthetic deep neck contouring, correction of platysmal abnormalities through revision platysmaplasty, redistribution or restoration of soft-tissue volume, precise fat grafting as needed, and revectoring and redraping of the plastysma/SMAS and skin layers to restore face and neck harmony and natural-looking transitions between the face, jawline, and neck.
The appropriate treatment depends on identifying the specific anatomical causes underlying what you are seeing on the outside; simply tightening the skin or adding and removing fat is extremely unlikely to improve the problem and could potentially worsen the existing contour irregularities or create new ones.
Since you're now approximately two years from your original surgery and well over a year from the revision, consultation with a plastic surgeon who specializes in facelift and neck lift surgery and is experienced in complex face and neck revision procedures would be reasonable. An in-person examination is necessary before determining whether another operation would be beneficial and what that operation should entail.

Need advice on how to correct deformity caused by deep neck lift. I feel more insecure now than I did before (Photo)

Answers (1)

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