67, male - persistent lumps appear after neck lift & revision (Photos)

Usually direct excision of this tissue should do the trick. Sometimes, excision and then elevating and re-tighening the skin is needed.

This is a cobra neck deformity. This is related to excessive removal of the deep fat in between the platysma muscle bellies in the midline of the neck followed by dehiscence (separation) of the two platysmal muscle bellies from the midline repair. The fullness in the midline could be residual submandibular glands or deep fat (below the muscle). It does not appear that the submandibular glands were adequately reduced. It also appears that the platysma muscle has separated and there is now a gap out of the midline. I would recommend a deep plane neck lift to reduce the deeper fat further, sculpt the submandibular glands, repair the platysmal muscle bellies back together and very carefully perform superficial fat liposuction. There may also need to do some superficial liposuction of the fat immediately below the skin needs to be very conservative as this fat is critical to having smooth, shiny and normal looking skin. You need to find an American Board of Plastic Surgery certified surgeon; ideally, this surgeon has also completed an aesthetic fellowship accredited by the Aesthetic Society.

This looks like either residual skin excess or scar tissue that has built up in the area under your chin. I would recommend a series of steroid shots (Kenalog) along with massage and possibly also microneedling to help. This can be a tough problem to fix but there is hope as I have seen this quite a few times in my 21 year career. Hope that helps!

Hello,
Thanks for your question. What you are seeing is the result of an initial fluid collection in the central neck at the time of your first face and neck lift. This can be difficult to revision from a submental incision alone especially in older patients because of lack of skin retraction. The stretched skin needs to be redraped laterally in many cases which means revising your neck lift. If you don't mind a slightly larger incision, your surgeon can get rid of much of this redundant skin and scar using a "T" shaped incision under the chin. It works incredibly well in all cases in my experience and reduces the amount of surgery, risk, and recovery.
Good luck.
Dr. Shah

The lumps in the photographs may be prominent digastric muscles, or submental fat, or sub-platysmal fat that was not addressed in the first or the second procedures. Copies of the operative report and an in-person exam are going to be required to make a determination about a bet how best to procede.

There appears to be some tightening that was done which is bunching up the tissue. This will need to be released. Go back and ask your surgeon to do this. The whole neck lift will need to be released to correct this.