Doctor said my neck lift didn't take because of skin elasticity. Are there other possibilities? Should he have to fix it?

Question

It didn't work....doctor said it is the elasticty. I think he didn't take enough skin. Are there any other possibilities to why it didn't work and what can I do about it? Should the doctor attempt to fix it?

George Yang, MD · Answer

Hi Lisasila,Your description did not come with enough information or photos, so it is impossible to say what happened.In general, if the patient's neck is sagging, and has sagging skin, muscle bands, and/or fat excess, there usually needs to be an incision under the chin (submental incision) to operate on the area under the chin.  If the surgeon only made incisions around the ears and behind the ears but nothing was done under the chin, then the neck can look somewhat improved for 4-6 weeks until the neck falls.  The stitches which tighten the neck from the sides can hold up for weeks until the sutures fail and the neck falls.  The skin is not strong enough to support the necklift and it will return to its original shape.  The procedure for the necklift which is more reliable is called a platysmaplasty or corset platysmaplasty.  You can ask your surgeon if this was performed.  Sometimes the sutures can fail in the platysmaplasty, but this is less likely than pulling from the sides.  The profile improvements that you see in the facelift and necklift before and after photos most likely all had some kind of a platysmaplasty.Not all surgeons feel comfortable performing a platysmaplasty.  The platysma muscle can be difficult to find for an inexperienced surgeon.  Also the comfort level of operating through a small incision under the chin can be worrisome if they are worried about bleeding and possible control of bleeding through this small incision.  The proper instruments and good lighting is essential to perform a platysmaplasty well.  Typically it takes me 30-50 minutes on just this platysmaplasty portion of the necklift to make sure I have actually isolated the platysma muscle and not have any extra fat or other tissues in the way.  The platysma muscle is also freed up as far to the sides as possible to make sure it can be slid to the center as the left and right muscle are sewn together.Hopefully this gives you some information to discuss with your surgeon.Good luck and I hope you find a resolution to your problem with your surgeon.Best,Dr. Yang

Jed H. Horowitz, MD, FACS · Answer

If your surgery was recent, it could still be too early into your healing to determine if a #correction is necessary. Typically, it's best to wait 6 to 12 months depending on the reason for #revision. As with all #cosmetic surgery, results will be rewarding if expectations are realistic.
With any surgical #procedure and #revision, there are some risks of unhappy outcome or other complications which your surgeon should discuss with you during your consultation. Also, your procedure should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for additional revision surgery.
If during your healing, you have any concerns, it is suggested to call your board-certified surgeon or their medical staff and discuss those #concerns.

Steven Wallach, MD · Answer

I have seen a few patients that have early rebound laxity of the neck. Sometimes a small revision can go a long way. Good luck.

Todd C. Miller, MD · Answer

It is possible that you can get recurrent sagging after a neck lift procedure if you have a lack of elasticity in your skin. This most commonly occurs in patients who have a lot of sun damage or who were previous smokers or in older patients. Pictures would be helpful. You may want to seek a second opinion and see if there is agreement.

Curtis Wong, MD · Answer

As mentioned by the others, pre and post-op photos are really needed to help us appreciate what you consider a failed result.  No change implies to me that absolutely no benefit was achieved.  Techniques do matter as well.  As for revising it, what is your surgeon recommending and what is your surgeon going to charge for this?  It probably isn't a good idea to try the same procedure you just had and new full fees would make me search for another surgeon who is more willing to 'warranty' the work done.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

It would be helpful to see your photographs. Skin elasticity can play a role in healing after a neck lift. If it is truly a skin issues, there are other modalities like skin resurfacing procedures you may benefit from.

George Commons, MD (retired) · Answer

The most common examples of early relapse of neck lift is is older females ( late 70s 80s) and sun beaten damaged males of 60 plus.   Of course there is also the difference in humans and their skin.   Nevertheless there should always be some nice gain.   A relapse does not mean no gain or change, it just means a relapse.  Go and talk to your surgeon and have him take photos before and after and discuss with you.  You should always see some reasonable benefit.   My Best,  Dr C

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  It is true that patients with very thin, fragile, aged and sun damaged skin do not hold the correction and tightening of a neck lift or facelift.  However recurrent laxity or sagging typically occurs in the first 2 years as compared to 10 or more years in patients with more healthy durable skin.However if your failure of results was apparent immediately after surgery then your surgeon may have failed to adequately tighten the skin or more commonly failed to do muscle repair or platysmaplasty beneath the skin.

Doctor said my neck lift didn't take because of skin elasticity. Are there other possibilities? Should he have to fix it?

Answers (8)

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