Seroma, edema on neck under my chin? What is this? (Photo)

Question

Can someone tell me what this is? Seroma, edema? I had a face and neck lift on 1/20/16, and chin and cheeks fat graft on 2/3/16. These was done on another country. This thing under my chin showed up days after the fat grafting when I was already back in the States. I emailed my doctor and he said to massage the area twice per day for ten days but still my skin is not back to normal. Is this something that will resolve with time or should I consult a plastic surgeon or a dermatologist?

Vincent N. Zubowicz, MD · Answer

Considering the recency of the operation this could very well be swelling within some connective tissue bands. There's nothing to do now except allow the healing process to complete it self. The benefit of massage is doubtful

Keshav Magge, MD · Answer

Thank you for your question.  This could be a serum, scar tissue, or untreated platysmal bands.  I would recommend speaking to your plastic surgeon about your concerns, and they can examine the area and come up with a treatment plan.  All the best,

Christian Subbio, MD · Answer

The only way to know for sure what is causing these wrinkles is with an in-person examination by a board certified plastic surgeon.  If they are unrepaired platysmal muscle bands, then they would move and tighten as you animate your neck.  If they do not tense or change with neck muscle animation, then it is likely excess skin.  In my opinion this is unlikely to get any better with time. Search for board certified plastic surgeons in your area to get the discussion started.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

John J. Martin, Jr., MD · Answer

It doesn't look like you have a lot of edema or fluid here.  It looks mostly like the bands of the muscle and some extra skin.  You will need to see someone near you for follow up to decide how to resolve this.

Brian K. Machida, MD, FACS · Answer

Although it is difficult to say without examining you, some of these may be platysmal bands which will probably not go away with massage. It's best to seek consultation for a physical examination.

Bahman Guyuron, MD · Answer

The common complications related to the neck lift include collection of blood or fluid under the skin, infection, formation of scar bands, residual platysma bands, residual fat, too much thinking of the skin, protruding glands. From the picture that you have posted you may have scar or platysma bands. This certainly is not edema or seruma. A board certified plastic surgeon could differentiate between these two and most likely treat the scar bands with cortisone injection.

Jeffrey M. Darrow, MD · Answer

Without a direct examination it is not possible to tell you exactly what is going on.  It appears to be some residual laxity of the skin and platysma muscle although you mentioned you had some fat grafting of the area, so whether this enters the equation, I can't say.  Your surgeon knows what you looked like before your surgery and is in the best position to guide you to a good resolution.

Bhupesh Vasisht, MD · Answer

Cannot tell based on the photo that you are showing.  It is not easy to discern what is what.  This type of situation requires a good examination by an expert.  If there is a true seroma, it should be addressed sooner rather than later otherwise you will have residual changes that will be hard to correct later.  If it is just some swelling that might resolve on its own.  Seroma may require a drainage procedure and only a good trained plastic surgeon can make that call.  your best bet is to return to the surgeon who operated on this to help you through this.  Good luck. Dr VasishtSouth Shore Plastic Surgery

Alyson Wells, MD, FACS · Answer

Thank you for inclusion of the photograph.  The irregularity beneath your chin could be the result of over-aggressive fat removal in the area (allowing the outline of the muscles to show through the skin), loosening of the repair of the muscle with early recurrence of the platysmal banding, or the aftermath of resolving seroma in the area.  Having had surgery outside of the U.S. complicates your follow-up, but it is nice that you still have access to your surgeon by email.  Massage may indeed improve this area, and it is unlikely to make anything worse.  It would be optimal to have a plastic surgeon in your community who has an active facelift practice see you now in case you need any revision in the future.  It would also be helpful to have a copy of your operative report (in English) to show the plastic surgeon to know the exact technique that was used for your facelift.  Best wishes for continued resolution and improvement.

Sam P. Most, MD · Answer

One of the downsides of medical tourism is lack of follow-up.  What you see could be due to excess skin, swelling, blood accumulation/scar, or residual banding, among others.  A good examination and review of your operative record is in order, if you can get that.  Find a local facial plastic surgeon who can examine you and help you determine what to do next, if anything is necessary.Good luck to you!

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