59, female, neck still an issue after 2nd revision 4 years ago - can anything be done? (Photos)

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

It seems that too much fat has been removed from your central neck leading to this depression and visible plastysmal edges. A revision to bring the platysma together and possibly reduce digastric muscle fullness can be performed to improve your neck contour.

In some, but not all cases, the submandibular glands can be enlarged and\or ptotic. Therefore, some form of deep neck lift with reduction of the digastric muscles and submandibular glands, combined withh a platysmaplasty is really the only way to address your concerns at this point. I recommend seeing a Facial Plastic Surgeon who performs this procedure.

Yes, at this point a good platysmaplasty will reduce the folds and the appearance of submental hollowing.
Regards
Dr.J

Hello, hope you are well. What is demonstrated here in your photos is a cobra neck deformity. This is caused by overly aggressive lipectomy (fat removal) in the central portion of the neck, which is out of balance with the lateral portions. This causes the submandibular glands and digastric muscles to stand out in bas relief. A revision neck lift can address these deeper structures. Further fat removal or platysmaplasty is not the answer, and would worsen or not address the problem, respectively.
Best,Dr. Tower