Sagging, Rugged Neck Skin After Endotine Cheek and Neck Lift

Question

My mother went for a Endotine Ribbon cheek and neck lift a month ago due to sagging skin. But her neck and cheeks are starting to sag again and she's worried. The ribbons are also very noticeable now, and she has rugged skin under her neck. Is there any chance that she will stay with those signs permanently?

Vincent N. Zubowicz, MD · Answer

In my career, I have been witness to all sorts of foreign objects placed in the face to support an ersatz facelift. They never work. They are foreign bodies that get encapsulated and thus isolated from the surrounding tissue. They don't make sense and they don't work. A well executed facelift is safe and gives predictable good results using the patients own tissue.

Benjamin C. Marcus, MD · Answer

Here is what I tell patients:

	Small procedures get small results. To help a truly sagging neck a more involved procedure is usually required. This involves tighttening the platysma muscle in the middle of the neck and lifting it from behind. A simple pull from the side tends not to last.

John Bitner, MD · Answer

Unfortunately, the marketers of Endotine and those who purchase the product will try to use it is places where it doesn't do well. The best treatment for sagging skin and a heavy neck is a SMAS based cheek and neck lifting procedure. The Endotine, like the thread lift before, will not last and is often visible. The Endotine works well for forehead lifts and mid-face lifts.

Otto Joseph Placik, MD · Answer

The bad news is that the endotines are resorbable and don't maintain the result. Furthermore, they typically require minimal surgery, which does little to really rearrange the tissues and create a dramatic effect.
The good news is that the endotines resorb, leaving little permanent effects. This means that it can be repeated and since little rearranging was performed, a true face lift correcting the neck and face can be carried out. That is also bad news because I am sure that is not what you wanted to hear.

Toby Mayer, MD · Answer

Whether they call them minilifts, week-end facelifts, wire lifts, etc. the end result is the same in patients who need a conventional facelift. Minilift = mini-result! You have to remove the extra skin and tighten the deeper tissue to get a good result. She can have a full facelift at about 9-12 months later.

Brent Moelleken, MD · Answer

I wish I could tell you that further sagging would not occur. However with suspension techniques, they tend to be short-lived, in my experience. Visible suture material also typically does not improve without treatment.
Fortunately, it is possible to perform revision surgery in the majority of patients and convert their surgeries to bidirectional facelifts / cheeklifts, and usually remove the ribbons / strings / Endotines in the process.
This usually accomplishes the goal of the rejuvenation the patient sought initially, without the large amount of foreign material, and with much more smooth, harmonious, permanent results.

Peter Schmid, DO, FAACS · Answer

The Endotine appliance will eventually resorb since it is a dissolvable device. Unfortunately, most of the effect achieved with Endotine will be lost if the tissue was not surgically lifted, fixated and removed. This is the shortcoming of not only Endotine, but also the Thread Lift and other non-invasive types of procedures.

Andrew Pichler, MD · Answer

Some surgeons like to use endotine because it seems to be a less invasive approach which appeals to patients. Unfortunately there can be proeblems with this technique: recurrence, visibility of the endotine, irregularity of the lift, etc. Traditional necklifts are more enduring and predictable. The good news is that the endotine will disolve in time. As always preoperative consultation should give the patients the alterantives available and limitations and expectation of each approach.

Steven Wallach, MD · Answer

I would imagine with very thin skin, the endotine ribbons would be very noticeable. It sound slike your mother needs a better quality neck lift.

Robert M. Freund, MD · Answer

In order to get a great Neck lift, a doctor must address the weakening of the platysmal bands - these are the two waddles that develop with age. Anatomically, the platysmal muscle separates in the midline. The endotine procedure does not address the real problem. My favorite and most reliable treatment is the corset Platysmaplasty, make sure your doctor performs this procedure.

Sagging, Rugged Neck Skin After Endotine Cheek and Neck Lift

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