15 months post op, very tight "headstrap" feeling. Experience with “release” to relieve tightness?

Question

I had lower FL & necklift 15 months ago. Since theI’felt a very tight “headstrap” feeling as well as tightness behind my ears. Oddly, the former has improved as the latter got worse (tightness redistributing?). After having many many kenalog shots and botox, my surgeon & I have run out of options and are considering a “release”, where he cuts the “lateral lift” he previously did, separating the platysma from the mastoid. Has anyone had a positive experience with this? Thx.

Elie Ramly, MD · Answer

Thank you for your question. Persistent tightness or a “headstrap” sensation 15 months after a facelift and neck lift is no longer typical early postoperative tightness and deserves a careful in-person evaluation.
There are several potential causes, including scar tissue and fibrosis, tethering, tight platysma or SMAS suspension, or tension related to fixation of the lateral platysma around the mastoid region. Determining exactly which structure is responsible is important before considering surgical release.
A lateral platysma release can be appropriate in selected patients when examination confirms that a tight or tethered platysma suspension is contributing to the symptoms. However, simply dividing the platysma from its mastoid attachment is not without consequences. The lateral platysma is often an important component of neck contour and jawline support, and releasing it could potentially affect the aesthetic result or create recurrent laxity.
Since you have already tried conservative treatments without adequate relief, I would obtain your original operative report and seek an in-person evaluation with a plastic surgeon experienced in revision facelift and revision neck lift surgery. The goal would be to identify precisely what is creating the tension and determine whether a formal revision neck lift procedure or more limited intervention would offer the best balance between relieving your symptoms and preserving your facelift and neck contour.

15 months post op, very tight "headstrap" feeling. Experience with “release” to relieve tightness?

Answers (1)

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