Neck lift - skin shrinks back not trimmed much?

Question

Hi I am booked in for a Platysmapalsty with submandibular gland modification in April, with a mesh of small stitches in the neck for 3 days post surgery to hold it all in place. When speaking to the surgeon yesterday he said not much skin is trimmed at the sides, and that the skin magically shrinks back? How is that possible with noticeable excess skin / skin laxity?

Jason Emer, MD · Answer

These are all natural parts of the aging process. What we can do is try preventative treatments or get a neck lift / face lift earlier in the aging process. There are numerous non-surgical options available, and some can be used in combination to get best outcomes, but you would need a consultation with an expert.

Some options for skin tightening include:

- Thermage radiofrequency to heat the skin, tighten it over time, and prevent the aging process
- Ultherapy high-intensity ultrasound to contract the muscle, tighten the face and neck, and prevent the aging process
- PDO NovaThreads or InstaLift threads for immediate lifting without surgery and long-term collagen production
- Sculptra injections for collagen production to areas of the face and neck with crepey skin or early sagging
- BTL Exilis Ultra, Venus Legacy, and Thermi250 for monthly collagen stimulation with facials
- ThermiRF, Renuvion (J Plasma), or Inmode BodyTite for internal heating and tightening with or without surgery
- Fillers (or facial implants) to contour the jawline and chin to improve the appearance of the neck
- Face lift / neck lift with fat grafting and fillers if you need a significant improvement​

​I would suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​

Brian K. Machida, MD, FACS · Answer

Your skin could contract depending on it's quality and elasticity. But photos are needed to determine how much excess or laxity is present. If this is all being done via one submental incision, it is difficult to smooth out without side pulls but might work depending on your age and skin.

Robert T. Buchanan, MD (retired) · Answer

You sound more knowledgeable than your surgeon. The skin may redrape some after a platysmoplasty, but it will not contract much unless you are younger than 30. The "small web of stitches in the neck for 3 days" will do absolutely nothing  except, perhaps, cause unnecessary scarring. If you want to hold the skin in a position and get it to stay there, you need to hold it for about 3 months until the scar collagen has cross linked and will not stretch back to its original position. If you really have noticeable skin excess, the only way to correct it is with a facelift (I quit doing neck lifts because you always needed to remove skin in the face from where the excess neck skin came and, by the time you did this, a facelift was no more expensive with no greater recovery than the neck lift but gave superior results).

Neck lift - skin shrinks back not trimmed much?

Answers (3)

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