Why do I have indents & a V after neck & deep plane lift & what is causing the V? (Photo)

Question

I had a neck lift and deep plane facelift, and 7 months later I needed revision. Surgeon suggested lipo in my chin to better neck lift results and now I have indentation and a V, any idea what is causing this V and how can this be fixed to look smooth under my neck?

Randal Haworth, MD, FACS · Answer

It's possible that the V-shape and indentation under your neck are a result of uneven fat removal during the chin liposuction. It could also be due to a lack of support in the tissues and muscles under the chin, which can sometimes occur after facelift procedures.

To address this issue, you should consult with your surgeon to discuss possible solutions. Depending on the severity of the indentation and V-shape, options may include additional liposuction to correct the unevenness, fat transfer to plump up the area, or surgical revision to adjust the neck and chin contours.

It's important to have realistic expectations and to work with an experienced, board-certified plastic surgeon who can guide you through the process and help you achieve the best possible outcome.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding why you have an indentation and a V after a neck lift and a deep plane lift. I think the neck has been overstocked, or too much fat has been removed. In my opinion, I would suggest a revision neck lift. This can be done by placing the incision around the ear and lifting the neck. If you are not inclined to undergo surgery, the other modalities will be minimal. Minimal intervention modalities will include the application of Morpheus8 and botox for the platysmal bands creating the V-shaped area on your neck. The V-shaped area on your neck is due to the platysmal muscle hanging and the fat between the muscle being removed. That led to the indentation. Another method to minimize the platysmal bands would be an injection of Botox. This can help to relax the muscles in the area. However, for definitive treatment, I would suggest a repeat neck lift. Thank you for your question regarding why you have an indentation and a V after a neck lift and a deep plane lift. 
Sincerely,
Dr. Katzen

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Robert M. Lowen, MD · Answer

Dear Imojine,
   Since you had a platysmaplasty it is clear that the margins of the medial platysma are not together. The depression is commonly seen when too much fat is removed.  Surgeons are usually wary of taking out too much fat behind the level of the platysma, since this is what happens.  Re-operating the neck is challenging since there tends to be scar tissue that tethers the skin down.
   You could consider fat grafting in the depression, one or more times. That may level the depression and improve skin quality.  Then you could consider the MyEllevate procedure which is much less invasive as it undermines and frees the skin from the platysma, bluntly.  Then the suspension suture can be introduced to tuck up remaining platysma.  Also the procedure starts with cutting those central platysma bands to get a smoother appearance.  This is all done through tiny punctures that do not leave a scar.

Derek Fletcher, MD · Answer

The appearance of your neck is most likely due to failure of the platysma muscle repair (platysmaplasty) and overaggressive liposuction.  An in person examination and review of your operative reports will help determine the cause and the strategies necessary to improve your results.

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