Puckered skin in front of ears after neck lift. Any suggestions? (photos)

Whatever the cause, at only four weeks out, the rippling should improve to some degree over the next three months. My best advice is for you to massage this skin several times a day as this should help it redistribute, softening, and flatten. There is a good chance you will still have some very mild rippling in that area in which case an in office revision will be needed. This can be done under local anesthesia and relatively easily,And in my opinion is the quickest, most definitive solution to this problem, rather than multiple noninvasive treatments. .Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Thank you for sharing with the physician community here on RealSelf.com.  It does appear that you did indeed have an isolated necklift (versus a jawline and necklift combined approach). By having a isolated necklift (without the lower face and jowls being addressed), your surgeon started his/her incision in front of the earlobe and went underneath it and behind the ear in the back crease (with ending in the hairline behind the ear, most likely). There appears to be no incision along the front contour of the ear. Due to the apparent laxity and quality of your skin and the lack of incision in the front of the ear, the skin in the front of each earlobe was bunched up during closure. Usually in time (up to 6 months perhaps), this pleated skin can smooth out to some degree and appear just as normal wrinkles, which is acceptable. There is a chance that they remain bunched and unacceptable, and at this point (more than 6 months post-procedure) you may consider a small procedure to relift just that area of skin and adjust how it lays down. So for now just give it time to heal on its own.  Light daily massage over the area may be beneficial, but please check with your surgeon before doing so. Good luck!

This amount of puckering after 4 weeks is abnormal.  I would lift additional skin behind the tragus (the structure in front of the ear canal) and redrape the skin.  Your scar will be very well hidden and can be done in the office and takes less than 30 minutes to perform.

This is a common thing i see my area and I treat this with lasers and microneedling. Sculptra with radiofrequency/ultrasound skin tightening (thermage or ultherapy) also softens this and help keep the lift for longer.  Best, Dr. Emer.

Skin bunching in front of ear after neck lift?  This is what happens if a isolated neck lift is done without extending the incision inside the ear more superiorly. This may go down with time but if still present after 3 to 6 months you will need a revision.

Hi Marian, it looks like you had some bunched skin at the front of the incision line. You are still a bit early in the healing process and there is a good chance that this will continue to improve with time. If it persists after about six months I would consider a scar revision. I like to position the incision in such a way that the skin bunching problem is avoided.

The skin puckering will subside with time (6 mos or more) but most likely will not resolve completely. You will probably need a revision requiring a modified lift after at least 6 mos of healing from this last procedure.

Many surgeons prefer not to do short scar face surgeries - the puckered scar is from trying to keep the incision shorter than ideal for perfect tailoring. It might smooth out in months, it might not. Either way, if you had a little longer scar, it wouldn't have had to be purse-stringed and would be barely visible by a month postop.