Seeking aggressive revision. Neck tended to form adhesions over time and a wrinkled appearance after 1st neck lift (Photo)

Thank you for reaching out with your concerns about the need for an aggressive revision of your neck, particularly due to the formation of adhesions and a wrinkled appearance after your initial neck lift. Your history and the provided pictures have been very informative.
The optimal approach for your situation is a revision neck lift coupled with a corset platysmaplasty. The platysma, the vertical band visible in your neck pictures, is a key area of focus. The procedure involves an incision starting in front of the ear, curving around the bottom of the ear, and extending behind it. This incision allows comprehensive access to the lower two-thirds of the face and the entire neck.
A further small incision is made in the chin to expose the platysma. The key step involves reapproximating the platysma to the midline using permanent sutures, aiming to achieve a well-defined 90° neckline. Following this, the neck skin is meticulously redraped, suspended, and tightened to address your concerns effectively.
I understand your apprehensions, especially considering the adhesions and wrinkling that developed after your first neck lift. However, a revision neck lift with platysmaplasty is a robust and aggressive revision that should effectively remedy these issues.
I hope this answers your questions regarding the correction of vertical bands and crepey skin on your neck following a previous neck lift.
Sincerely,
Dr. Katzen

Your photos indicate a slender neck with minimal fat between the skin and underlying platysma muscle. Therefore, there will always be a tendency for the muscle fibers to become visible. You seem to have a prominent platysma muscle band, without any fat to camouflage it. I suggest a secondary necklift to include wide skin redraping posteriorly to tighten the skin, Partial cutting and removal of a small triangle of platysma muscle and suturing of the 2 platysma muscle borders together and upward. This should create a firmer, smoother neck contour and angle.

I believe that a revision neck procedure would be ideal to address the loose skin and loose platysma muscle band underneath). I would recommend finding a plastic surgeon with at least 6-7 years of training in actual plastic surgery.