Is there a surgical touch up procedure that can be done under the chin to get rid of loose skin after a neck lift? (Photos)

Question

Is there a surgical touch up procedure that can be done after a neck lift to get rid of loose under chin skin? I am 6 weeks post op from a lower face and neck lift. I am very happy with the face lift but as the swelling is going down in my neck I have a lot of loose skin under my chin. Every day it seems to get worse. I have incisions behind and in front of my ears but not under my chin. I spoke with my surgeon and he thinks it looks fine

Robert N. Severinac, MD · Answer

Thank you for your question regarding excess residual skin after neck lifting.Please look at my before and after face and neck lift patients in the link below before reading on...Residual excess skin like you have under the chin and jaw area is not uncommon following neck lifting.I can't tell from your pictures of what type of neck lift you had done.  Sometimes redoing the procedure can remove more of the loose skin such as through incisions around and behind the ear.   But if you had a procedure that just addressed the deeper tissues support (plastymaplasty) and bulk (lipectomy or liposuction) where there is no skin excision then redoing the procedure will not help.I have found direct excisional techniques can remove this area effectively.  This means the excess skin is removed through patterns directly where the excess skin is.  In your case, the skin would be removed though an inverted T excisional pattern with a repair down the midline under the jaw and another across the neck where you already have a wrinkle.  This can be done comfortably in the office setting under local anesthesia with oral sedation.Now lets go back to the link and the last before and after.  All the patients I have shown this picture to during consultations didn't notice the vertical repair on the neck.  This was done as a second procedure to remove some residual neck skin.. not surprising given the amount of excess skin there was initially.  She was elated.Direct excisional techniques on the face and neck are in some ways thinking outside the box.  Plastic surgeons are concerned about making incisions hidden along anatomical lines such as around the ears and along hairlines.  Direct excisional techniques require closures that can be more visible.  It has been my experience that these repairs heal very nicely and are not noticeable in everyday life.All my best!

Jason Emer, MD · Answer

​A combination of non-surgical options like Kybella, PDO NovaThreads, Ultherapy and Thermage would do well in combination for skin tightening for the neck. VASER Liposuction (with ThermiRF, Renuvion and InMode FaceTite) is a great alternative for contouring and tightening the chin and neck and can be combined with a neck lift at the same time, if you're a candidate. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a long-term treatment plan that works for you. Best, Dr. Emer.​

Cameron Chesnut, MD, FAAD, FACMS · Answer

A revision neck lift has the ability to rearrange and adjust amounts of tissue, thus it can remove excess skin and tighten those muscle bands. Nonsurgical skin tightening treatments can improve the quality of the tissue left behind,  which can have an immediate affect and help age proof your neck and jawline moving forward. 
Overall, tightening can have improvement to the jowls and neck to some degree, but they do not truly alter the amount of position of those tissues.  When true tissue excess is present, whether that is skin, fat or muscle, surgery is needed. 
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut 
#realself hall of fame Physician

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. There are lasers used as touch-up tools after surgery, however, it is much too early to decide definitively that you require any touch-up or revision. Please remain patient during your healing process. Please continue to discuss your recovery results with your board certified facial plastic surgeon.
Best wishes,

Douglas L. Vander Woude, MD · Answer

Thank you for your question.  It sounds like you are pretty early in your recovery process. You may, at some point, be a candidate for a bit more tightening of the skin for a smoother look, but it is very early.  Let things heal and soften for at least 9 - 12 months before considering any additional treatments.

Kenneth D. Steinsapir, MD · Answer

I strongly recommend letting your surgery heal a full 6 to 12 months before deciding that you need a touch up.  The skins does seem to tighten as the procedure heals.  That does not mean that all of your loose skin will resolve.  Time is very helpful here.  It is hard to be patient.

Vaishali B. Doolabh, MD, FACS · Answer

Hi Maureen 1234.  If the skin pleating resolves when you pull near your earlobe, then a revision by re-opening your existing incisions is reasonable.  If it doesn't, then a pull forward may answer whether a new incision under the chin is necessary.  You may look into non-surgical, skin tightening options like Profound radio frequency micro needling,   Consider an in-person second opinion by another ABPS certified plastic surgeon. Good luck!

Richard O. Gregory, MD · Answer

This is a common complaint and occurs usually because the skin has loosened after the swelling has receded.  It also depends on what the condition was prior to the surgery and what surgery was done.  Several options:  let it go until the next time you need more in several years, tighten skin with laser externally, or use an internal procedure such as radio frequency (ThermiTight, Facetite, etc)  All of these have their limitations so go to a surgeon whom you trust and maybe even get a second opinion.  I do not have a lot of faith in ultrasound and some other external tightening procedures.

Is there a surgical touch up procedure that can be done under the chin to get rid of loose skin after a neck lift? (Photos)

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