Stringy Lax Neck Skin Returning 9 Weeks After SMAS Face&necklift?

I had a SMAS face&necklift 9 weeks ago for stringly waddle hanging from chin to base of my neck..w/ mucsle plication under chin. The stringy waddle/ lax skin is returning. Surgeon says things will pan out. I anticipate it will get worse since I still have a lot of facial swelling holding it up and the sutures are not yet dissolved. Is it possible to attach the waddle to the underlying muscle to hold it up w/out ear incisions? FYI..surgeon was a facial plastic surgeon. Thanks!

Doctor Answers 7

Loose skin after a facelift or necklift can happen 5-10% of the time

By far the most common reason for dissatisfaction after a facelift or necklift is the return of some degree of loose skin. While certainly not as bad as before the surgery both patients and surgeons hate when this happens!

It can occur after any type of technique used on any patient and when done by any surgeon. It is a reality of what can happen after surgery.

The good news is that after waiting for 6 months it can be easily addressed. Most surgeons are more than happy to do it to make for a happy patient and to make themselves happy with the work they have done.

Take care,

Dr. J

New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Lax Neck Skin 9 Weeks after SMAS facelift

    If this is a skin issue 9 weeks after a neck lift there may be some remodeling of tissue depending upon the area that was undermined.  If there is too much skin at 6 months, consider a revision to remove more skin utilizing the ear incisions.  Kenneth Hughes, MD facelift Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Residual skin laxity after facelift

Residual skin laxity can occur with a facelift and is not as uncommon as you think. Sometimes a small revision can help improve it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Lax Skin After Facelift

Lax skin can occur after SMAS or any type of facelift regardless of the technique or the surgeon.  This is unfortunately one of the most common issues with face and neck lift procedures.  I would probably recommend waiting six months and revisiting the issue with your surgeon. You may need a "tuck-up" procedure to revise the issue.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews



The recurrence of the neck Waddle, will depend on the technique used. Many surgeons call their facelift SMAS facelift, but there are different approaches. Wasit lifestyle facelift, quick facelift?

The appearance of laxity of the neck early will not improve with time. If the facelift did not include neck lift then you will require a neck lift with incision behid the ear and extending to the hairline in the back of the ear.

You may want to consult a Board Certified Plastic Surgeon (American Board of Plastic Surgery (approved by the American Board of medical Specialties).

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Getting the neck right

Without seeing you in person one can only speculate. However - early return of neck bands does occur. I agree that these will likely become more rather than less prominent over time. While no neck procedure is perfect I agree that in my hands I find a more aggressive neck approach to be required. I do divide the platysmal and attach it to the cervical fascia rather than just sew in the midline



Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 43 reviews

Lax Neck Skin after SMAS Face & Neck Lift

It is difficult to make a good assessment without examing you.  I would agree with you that the laxity will probably get worse as the swelling continues to resolve.  The stringy waddle may be due to banding of the platysma muscle.  In my hands this is best addressed by dividing the muscle low in the neck and bringing it together in the midline.  Attaching the skin to the muscle would not be a good idea.  The direction for removal of the skin is actually perpendicular to the laxity in the neck, which means that for you to get skin tightening of the neck you need to have incisions behind the ear and along the hairline.  These incisions heal well and are quite invisible.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.