Solution for neck/chin - 4 1/2 months post op? (Photo)

16 months ago face/neck lift (incisions in front & behind ear and small one under chin) left me with excess skin under chin and neck bands. Had revision (platysmaplasty and excess skin removal) and now 4 1/2 months post op and look actually worse. Banding is diminished (except little bit on left) but under my chin looks awful. Scar is horrible. Why is it so puffy/saggy looking/uneven? It doesn't feel like fat. What could be the cause? What can be done to fix? This was board cert surgeon

Doctor Answers 1

It is important to understand that facelift training for general plastic surgeon is very thin.

In very good plastic surgery residencies, the amount of cosmetic surgery training across the country, is not uniform or extensive.  Most plastic surgery residents are lucky to complete a single facelift as a primary surgeon.  Few go on to do an aesthetic surgery fellowship after residency.  Instead, most hang out their shingle after residency and learn on their own what many might assume what they should have learned in training.  This has a direct bearing on the quality of the cosmetic surgery practiced by our general plastic surgeons.  Some are exceptionally excellent at learning on their own and in weekend courses, but some not so much. Your surgeon appears to have directly removed "excess" skin from the incision under the chin.  In the attempt to finish the edges of this excision, the surgeon "chased" the dog ear necessitating an incision that is visible.  Ideally this is not done for this precise reason.  Additionally there are tension lines related to this excision-essentially your are short of skin here. For this reason, most experienced facelift surgeons avoid this maneuver and limit skin excision to the side of the face.  At 16 months the issue is not going away on its own.  The scar is depressed.  A very carefully designed scar revision may help this.  Second opinions are warranted.


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