Crepey skin on neck after thyroidectomy: Will it go away on it's own?

Question

I had a total thyroidectomy three weeks ago, 11/21/2017. After two weeks, the surgeon removed the Steristrips on the incision. The incision looked good. But in a few days, I noticed that the skin above and below the incision is very crepey. My Thyroid was very large, and I am very thin, so the surgeon removed some skin during the thyroidectomy. Will this crepey skin get better on it's own? If not, what treatment will improve it's appearance? I plan to start Silagen sheets in a few days.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

Without photos, it’s a little difficult to address your problem specifically. However, most crepey skin can only be treated with a neck lift that actually removes excess loose skin. That said, I’d advise you to wait until you’ve completely healed before deciding on a course of action. I hope this helps.

Zoran Potparic, MD · Answer

You should wait at least 6 months after surgery to see how much would neck skin retract. In the meantime non-invasive treatments based on ultra sound, radio-frequency may help. If skin is not sufficiently retracted after 6 months, anterior neck lift or lower face/neck lift should be a consideration. A consultation with a board certified plastic surgeon with good reputation in facial rejuvenation would help to discuss your options. Good luck.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist for after care recommendations. I recommend Silagen + Bioshield to promote healing. Kybella, PDO Nova Threads, Ultherapy and/or ThermiRF treatments (Venus Legacy) are non-invasive options that would do well in combination for skin tightening. VASER with ThermiRF is a great alternative for contouring and tightening the chin and neck. See an expert for a long term treatment plan.  Best, Dr. Emer

Vaishali B. Doolabh, MD, FACS · Answer

Hi.  There are treatments that will help the crepe skin, but you want to be sure to wait for the area to fully heal.  Profound radiofrequency microneedling is very effective as is J Plasma subdermal coagulation.  Have an inperson consultation with an ABPS certified PS when you are cleared by your Thyroid surgeon.  Good luck!

Mark Taylor, MD · Answer

Crepe skin on the neck is a classic sign of aging and often du to excess unprotected sun exposure, genetic, overall skin call and simply the signs of aging. The devices that can help include ThermiRF, LaserLipo (with or without suction), RF MicorNeedling (Intensif, Fractora, Profound, Infini), Ultherapy, Laser Tightening (Fontona Piano Mode) & laser resurfacing (Fotona Smooth Mode), eMatrix, SkinFinity, Neck surgery will help laxity, but not correct all of the crepe appearance. Check with a cosmetic dermatologist or plastic surgeon who has all of the options and lots of before and after photos of patients they have treated. This is not an easy project, however substantial improvement can be achieved. It is a similar project to the challenge of treating stretch marks.

Arian Mowlavi, MD, FACS (license on probation) · Answer

I would not waist money on any procedures until 3 months following surgery when all the inflammation and swelling will have resolved. Then you need a consultation with a face and neck specialist to let you know the best course of action. Silicone sheeting and gells are only good for the incision line.

David Alessi, MD - Account Suspended · Answer

I have seen this after thyroidectomies before and it typically doesn't go away.  Your options are non-invasive Profound RF  or maybe a neck lift.  I would suggest the Profound for now to give more time for the neck to heal from the surgery.  Of course, an in-office exam is needed for a detailed plan.  Best wishes.

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