What could be done? Not completely happy with my face lift and neck lift after 4.5 months. (photo)

Thank you for your question and for attaching photos. It does appear you have a less than optimal result based on your photos. You do have some remaining platysma bands and excess submental fullness. You should return to your surgeon and discuss your results. You should have your surgeon print your before and after photos (or use the imaging software) so you can both review these images and come up with a plan to improve your results. Don't be surprised if your surgeon wants to wait until you are at least 6 months out to perform a revision. This is the best option for optimal healing. Best of luck. 

This is a severely challenging problem to fix in the neck. This is due to inadequate primary treatment of the neck at the initial surgery. The muscles were not adequately addressed. The fat was inadequately sculpted. The large glands of the neck were not treated. This requires a very comprehensive and aggressive surgery to fix this. You need a VERY confident and experience board-certified plastic surgeon with extensive experience in the face/neck. Ideally this surgeon completed 6 years of integrated plastic surgery training followed by a 1 year aesthetic fellowship endorsed by the Aesthetic Society.

You do have excess platysma banding with probably some residual skin on you neck as well. In these photos you are animating the neck muscles so this will accentuate the deformity. Send a front and profile photos with your muscles relaxed, to help us better evaluate this issue, most likely your neck won't be a bad as these photographs seem to illustrate. See if your surgeon will revise your neck with a plastyma-plasty at 6 months, you appear to be a good candidate.

It does appear that you have some persistent platysmal banding and submittal fullness. That being said I would discuss your concerns with your surgeon and ask him/her what they perceive about your results as they have your preoperative photographs. You may require a revision at some point but I would wait until your are completely healed between six months and a year before you consider any additional surgery.

It is difficult to provide an answer to your question without seeing a complete set of pre-surgical photos and reading a dictation of the surgery but it appears that you have much excess neck skin and platysmal banding. It is unlikely to improve with further time. As far as your neck, I would recommend a platysmaplasty and a revision of your neck lift. Some skin relaxation is expected but this is not going to get better without further surgery. In most cases, the recovery from revision surgery is easier than the primary surgery. 

It s hard to give a comprehensive evaluation without seeing the rest of the face. You need the bands addressed but I wonder whether this can be addressed by itself or whether it requires a more extensive approach.

Hello,
Based on your provided photos, it seems that you have much excess neck skin and platysmal banding. It is unlikely that it will improve  with further time. ı can  recommend a platysmaplasty and a revision of your neck lift. Some skin relaxation is expected but this is not going to get better without further surgery. You need to a facial surgeon who is professional on facial cases.
Regards,

 The photographs are not adequate in order to make a determination about how best to proceed.  A full set of facial photographs from all angles with  your hair pulled back  and your chin in a neutral position are required to make a determination about how best to proceed.   The Photographs should be non-animated as well. Residual fatty deposits in the neck can be removed with a neck lift and liposuction.  The platysma bands can be addressed with a platysma-plasty.  Also important to determine the amount of skin laxity, which must be determined at the time of an in-person examination.