Would a revision neck lift remove excess jaw skin? (Photos)

Question

I had facial surgery about 5 years ago that included jaw contouring and a neck lift. My face was really swollen and the neck lift didn’t really help. I have a lot of excess jaw skin when my head in a neutral position that I’d like tightened. I’m wondering if a revision neck lift would be the right approach to bring out the contour of my jawline.

Gianfranco Frojo, MD · Answer

I would recommend a secondary/revision facelift/necklift including deep neck work such as addressing the submandibular glands and deep fat while also contouring the platysma muscle of the neck. It does not appear that the submandibular glands were reduced at the initial surgery. It also appears that there is now redundant very loose skin. You need to find an American Board of Plastic Surgery certified surgeon; ideally, this surgeon has also completed an aesthetic fellowship accredited by the Aesthetic Society.

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs. While a neck lift revision can achieve additional skin tightening, it is essential to approach this with careful consideration of the quality of the scars. Over-tightening the skin can lead to issues, such as problematic scarring, and may also cause traction deformities, like pixie ear deformity or pulling of the earlobes.

From your front-view photograph, there appears to be some residual volume below the level of the jawline. This suggests that there is still fullness related to the digastric muscles. A revision neck lift procedure, if designed to include volume reduction deep to the platysma muscles, can improve the overall contour by addressing both skin tightening and deep volume reduction.

It is important to note that the improvements from such a revision would likely represent marginal gains. However, these gains are additive and, when combined, can translate into a result that you may feel more comfortable with.

Manish H. Shah, MD, FACS · Answer

Hello,
Thanks for your question.
In all actuality, you would be better served with deep plane facelift to lift the loose skin in a vertical manner to better redrape and sharpen the jawline. Repeating a necklift would attempt to pull the skin in the wrong vector and would create a contour irregularity. 
Many patients try to avoid a facelift and go with neck contouring alone. Neck contouring procedures focus more on the central neck and give patients a more angular neck profile. Occasionally in a younger patient, the jowls get a little pull but no real lift. 
In your pictures, you clearly show skin laxity above the jawline so that skin needs to be redraped elegantly with a facelift.
I hope this helps.
Good luck!
Dr. Shah

Carey Nease, MD · Answer

Based on your photos, a revision of the necklift procedure may be indicated. The excess skin on either side of your chin is common when the skin in this area is not completely released during the initial procedure. Other options for mild improvement would be microneedling with RF energy, and would take a series of 3-4 treatments. Since you didn't mention your age it's hard to say how well you would respond to that treatment. I hope that helps!

Mitchell Hagen, MD · Answer

Thank you for this question! There is so much variability in face and neck lift procedures amongst surgeons and it is difficult for patients to sort through this information. Some of the most variable is in the neck. Most surgeons perform different types of neck procedures specific to each patient's unique anatomy. These range from deep neck lifts to liposuction or a combination of both. It appears from your pictures that you have excess skin laxity as well as fullness in your neck. Typically the face and neck should be lifted together as the layer that is lifted (SMAS/platysma) is contiguous in the face and the neck. From your photos, you would likely benefit from a revision necklift as well as a revision facelift (at least lower) to address the skin laxity around your jowls and jawline to meet your goals. To answer your question, you would be able to remove a substantial amount of excess skin. Surgeons that focus specifically in facial rejuvenation procedures and revision face/neck lifts are the ones you should be seeking out. This is a big decision so I would take your time and consult with several surgeons to find someone that you are comfortable with. They should be able to show you before and after pictures similar to the result you would like to achieve. Good luck!

Chet Mays, MD · Answer

Thank you for your inquiry!  We would love to meet with you in person to help discuss your options. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Sean Fisher, MD · Answer

It is difficult to say what would be needed based on the limited photos provided. Also, specifics about what was done surgically would be helpful as an isolated neck lift could entail a procedure either performed through a submental incision only and/or with an incision behind the ears. Depending on what was performed and a full set of pre-operative photos, a more accurate assessment of what would be needed would be possible- this could possible require either a revision neck lift, an alteration of the type of isolated neck lift performed or combining additional neck work with a face lift. A well trained plastic surgeon with experience in facial rejuvenation will be able to assess this for you and have a discussion about the best approach. 
Sean Fisher Aesthetic Plastic Surgeon Seattle, WA

William Portuese, MD · Answer

Much more information is needed, such as your age, and a full set of facial and neck photographs from all angles,  in addition to a copy of the operative report to find out what was accomplished in the first procedure.

Darryl J. Blinski, MD · Answer

Based on your posted photos, I agreed that a revision mini face and full neck lift with Endo lift laser treatment in combination is recommended. Fee $15,000-$25,000. Best virtual consult with.

Emine Demir, MD · Answer

i recommend lower face and neck lift surgery We perform a deep plane surgery, meaning we lift the muscle (SMAS) and the skin, which enhances the longevity of the results. This approach provides a natural outcome while maintaining the overall aesthetic of the face

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