Is this double chin 12 weeks post deep-plane facelift acceptable/normal? (photos)

Question

Hi there. I am 12 weeks post deep-plane face lift with platysmaplasty and removal of fat pad. I am confident in my doctor and can feel the work he did. What could be causing bulge/sagging. I am concerned that it may get worse. This is actually my second facelift, though first one was done is Mexico, and nothing seems to be have been done under the skin. Should I just give up? Can this be corrected? I so want a flat, 90-degree neck, and I have paid so much money and time and have so many scars.

Philip Solomon, MD, FRCS · Answer

You likely still have swelling.   If you developed any post surgical seroma or hematoma this could take  a few months to settle and cause prolonged swelling in the neck.   After full healing if you have persistent fullness in the neck then a limited direct excision and revision platysmaplasty may be required.

Boris M. Ackerman, MD · Answer

The fullness in your neck could be due to enlarged salivary glands, or enlarged digastric muscle.  It is not uncommon to "unmask" these structures once the overlying fat is removed during a face-neck lift.   An experienced and talented surgeon can properly assess the patient pre-operatively, and be prepared to deal with this issue during the surgery.Only an in person evaluation can determine what remaining structures are causing the residual bulge in your neck. Any further revision surgery should await up to a year after your last face lift.

Walton Montegut, MD · Answer

This is a good question. The healing time after surgery is usually a minimum of 3 to 6 to 12 months for swelling to resolve. The body heals along this time line and swelling and pain resolve accordingly. Looking at the photos you posted, it appears as if your neck could be tighter at this time frame. A good Facelift  includes the Neck and it needs to look as good as the Face.  Many surgeons do not master the details required for the neck to look sharp and tight.  There are several surgical maneuvers that can be performed for the neck to look very good. This includes a tightening the platysma muscle and creating a sharp Cervicomental Angle.  This usually involves cutting the platysma muscle in a certain way to delineate the angle of the neck. Also, if the neck is full, the tissues need to be examined appropriately.  Sometimes the anterior belly of the digastric muscle creates a fullness that can be eliminated surgically.  Adding this to the procedure will help create a sharp neck.  This is a especially important in a Male facelift because the fullness is usually present. I always remove part of the digastric muscle in men because if helps to sharpen the angle. These concepts are unique to creating a youthful neck.  The Neck is as important as the Face and should not be overlooked.  In your photographs it appears as if you still have fullness present that may remain as you heal. If so, then you may need a revision. At the time of surgery, the surgeon should see the result on the table and check for the proper result.  If not, then continue to create the best neck surgically at that time.  I hope this helps.  If it continues to remain full, you will need a revision. Sorry that is not what you wanted to hear, but ...... Good Luck.

Robert H. Woods, MD · Answer

This looks like you did not get the expected result. Based on your description of a fat pad removal and a platysmaplasty I would have expected a better cervicomental angle. Possibly did not remove enough fat, skin, or both. Possibly did not tighten the platysma enough or the stitches failed. This will not get worse, but you should consult with your trusted plastic surgeon and see what he can do to get a better result or explain why he cannot do any better than this. The deep plane part of your surgery has nothing to do with the submental region.

Curtis Wong, MD · Answer

are challenging to achieve day in and day out and your pre-existing anatomy will also impact that.  Did your surgeon tell you that you would have a 90 degree angle?  If so, then you have a legitimate concern.  If not, then the best you can do is to let your surgeon know of your concerns and see if options are available to you down the road once considered healed.

Richard P. Rand, MD, FACS (retired) · Answer

Once there has been previous surgery, it is almost never possible to produce an optimal 90 degree tight neck in a secondary surgery because of scar tissues and the effects of the first surgery. Especially if there was liposuction done the first time.The very best necks are generally seen in the hands of the best surgeons, with that being a virgin neck. If you trust your doctor please stick close with them through the healing and follow all of their advice. You won't be entirely healed for over 6 months from the surgery so there is still healing to do.

Is this double chin 12 weeks post deep-plane facelift acceptable/normal? (photos)

Answers (6)

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