I Have What Looks Like A Rope Around My Neck Following Facelift/Necklift

I had a face lift and a neck lift a month ago. As a result, I now have what appears to be a small rope around 1/2 of my neck. Additional my right side of my face is far more doopy than my left, ( which is good). I go back to the Dr. in 10 days for my 6 week evaluation. Is this something that he should fix? 

Doctor Answers 11

Definitely worth discussing with your surgeon.

This is a bit unusual.  However, swelling and lumpy fullness following facial surgery can remarkable works its way out with time.  Your surgery should recognize if he or she did some type of manipulation that resulted in this roll or if you had a hematoma or seroma that accounts for this appearance.  I would encourage you to call your surgeon and be seen earlier than what you are currently scheduled for.  This concern should be evaluated by your surgeon.  It is better to be seen for something that turns out to be nothing serious than to miss something that turns out to be important.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Disappointing facelift/necklift results!

This area of subcutaneous scar fibrosis causing "banding" in the neck is usually the result of undrained hematoma or seroma. Did you have a drain? Was it removed only after the drainage had diminished? Did you wear an elastic chin strap and limit activities in the first 2 weeks after surgery? Did you have a lot of swelling and bruising after surgery? All of these play a role in any such occurrence, but when I have seen this, re-operation is almost always necessary, but not sooner than 6-12 months after the initial surgery, and only after infrared, ultrasound, and massage therapy has been used (along with time) to soften the scar tissue as it matures on its own. Rarely, steroid injection into the scar fibrosis can help to soften and flatten the areas of "bunching."

Aside from the neck banding, your result on both sides, but more so on the right (as you have indicated), is just not very good. Perhaps you had significantly looser skin and much more deep nasolabial and subcommissural folds pre-op, but regardless of the severity of your pre-op skin laxity, this result should be better. Actually, a fair amount better, IMHO.

So, either way, you likely need a revision facelift/necklift. Please verify the training, experience, and board-certification of your surgeon (American Board of Plastic Surgery is the ONLY ABMS board that certifies real plastic surgeons--there are other ABMS boards that certify doctors who perform cosmetic operations without complete plastic surgical training, as well as a few "bogus" boards). If you need to, obtain several other consultations over the next few months with experienced ABPS-certified plastic surgeons who do lots of facelift surgery. This will help you decide if what your own doctor is saying is accurate and realistic. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Rope around neck

This almost looks like an endotine ribbon which can be used to lift the neck. If so they dissolve over 6-9 months. If not it may just be persistent edema demarcated in an isolated area. see what your doctor thinks. He/she is in the best position to know exactly what was done and what the prognosis is.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Male face lifts take time to settle in

Most necks (and faces) are uneven to begin with and the difference in the two sides usually represents both differences in early healing and what might have been done differently on each side to adjust the neck.

Regarding the thickening in the neck - that also may be due to what was done in the underlying structures of the neck. It also may be due to a prior collection of fluid in the neck (seroma or Hematoma)  which also usually will settle out, but may require some manipulation after several more months if it does not.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon
4.3 out of 5 stars 7 reviews

Talk to your surgeon

about your concerns.  Many have speculated as to what has happened but in reality, your surgeon is best prepared to know what may have caused your problem and can come up with the most appropriate solution.  If it does not improve, your results will be considered subpar and hopefully your surgeon can help guide you through the revisions that will be needed to correct your problem.  Without knowing your pre-op condition and just what procedure was done, everything is simply speculation.  Talk to your doctor.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Ropy swelling on neck

I agree with others that this is likely the result of a hematoma.  You should see your surgeon sooner than later and consider steroids injections and masage

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

The neck rope looking things look like where the drains used to be

This condition can occur if the drains are taken out too early and there is fluid in the drain tracks that form scar tissue.  At this point, there is likely some scar tissue there and may be hard to remedy.  You could use some steroid injections.  If there is still fluid, I would express them out through a small incision or with a needle and syringe.  Hopefully that is all you need. These tend to resolve though.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Resolving "Ropey" appearance

It has been approximately five weeks since the procedure and generally at this time healing issues, bumps and lumps and “ropey” appearance problems have resolved.  However in a small percentage of individuals this can be a persistent manifestation.  Bumps and lumps and ropey appearance can last longer than five weeks, even into the three month mark.  Generally, according to the appearance of the picture, there is no evidence of infection and this is simply an area that is going to take longer to heal.  The reasons this happens is sometimes unexplainable, sometimes related to the way bandages are placed or it can occur with slow accumulation of fluid and/or blood into the tissues underneath the skin.  Ongoing observation is still the mainstay of treatment.  Massage can be beneficial I believe and sometimes ultrasound treatment to the area can help accelerate the wound healing process. 

David Q. Santos, MD
Bellevue Facial Plastic Surgeon
4.3 out of 5 stars 23 reviews

Rope around neck

it is difficult to say exactly what is the  cause of your issue.  what does your surgeon say?   most issues do get better with time.  if you do need a revision wait at least 6 months from the initial surgery

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 64 reviews

It can be corrected if not better in 3-6 months

The bands that you see under the neck is because of limited undermining at the chin and too much fat removal from under the chin. This can be seen also in patients with poor skin tone . You need to see your surgeon as soon as possible to start you on Endermologie or lymphatic drainage message. If this is not resolve in 6 months ,revision can help. You need to start message ASAP before too much scar formation under the chin.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

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