Repair of a cobra neck deformity. What would be the best option?

Question

I had a neck loft on July 9, 2013 and have a cobra neck deformity as a result. The dr who performed the original surgery seems to think redoing the platysmal bands would be the best option but after a second consult I was told a revision lower face and neck lift should be done but I don't need the facelift part yet. I'm the meantime I need something as I just hate it. I'm now confused and feel like the facial plastic surgeon who originally performed it has no idea what he's talking about.

Raffy Karamanoukian, MD, FACS · Answer

Our office specializes in neck lifts and neck lift revision surgery. Replication of the neck bands and platysma may be an excellent option provided the platysmal demarcation is clearly visible and not splayed. Best, Dr. Karamanoukian Los Angeles

Jason Emer, MD · Answer

Please provide pictures of your neck to determine which is the best procedure for repair.  Most of the time however, a neck lift and revision platysmaplasty is needed.  Best, Dr. Emer.

Toby Mayer, MD · Answer

I need to see photographs to determine what is the best way to handle this. Often a platysma plasty will accomplish your goals, but not always. Resubmit photos. Look at results of natural looking facelifts from an experienced with facelift surgeon for the best results.

R. Laurence Berkowitz, MD · Answer

If you are referring to redial bands with a central depression under the chin it is a perplexing problem for us. An exam must be done to distinguish what structures are causing the problem and a review of the operative report from your surgeon to see what was done originally.  It has been my experience that to struggle with the muscles in the neck in the face of loose skin is not fruitful. It may in fact be necessary to redrape the skin with a lower face and neck lift.

Dino R. Elyassnia, MD · Answer

As the other doctors have mentioned, it is very difficult to give a proper diagnosis and optimal treatment plan without examining you but what I commonly have seen is removal of excess fat centrally in the neck without treatment of the submandibular glands which gives the appearance of two lumps on either side of the neck with a central depression below the chin.  The solution is a neck lift that involves contouring the deep space of the neck which includes reduction of the size of the glands along with treatment of the deep fat and possible digastric muscles in addition to a platysmaplasty.

Richard W. Fleming, MD (retired) · Answer

Platysma  revision with removal of the cobra deformity and a neck lift is the most common and efficient way to treat this problem. Unfortunately I'm speculating without seeing you or pictures.

Repair of a cobra neck deformity. What would be the best option?

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