2 years post op, unhappy with neck lift results - will a revision correct wrinkles and dip at the top of my neck? (photos)

Question

I had my neck lift almost 2 years ago, and I am not happy with my results. My neck still has wrinkles, but the worst part is the dip at the top of my neck. Can anything be done to correct this? I would love advice on what I should do. Thank you.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. I’m sorry that you’re unhappy with your initial neck lift results. You do appear to be a candidate for revision neck lift surgery to remove excess skin and fat from the neck and throat. The remaining skin can then be tightened to create a smoother and more well-defined contour. It’s possible that an additional procedure known as platysmaplasty may be recommended to also tighten the muscles of the neck as well as the skin to achieve the best results.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your surgical history, discuss your concerns with you, and help you decide on the best treatment option.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your surgical history, discuss your concerns with you, and help you decide on the best treatment option.

Jason Emer, MD · Answer

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.

Bianca Knoll, MD · Answer

thank you for posting your picture. It is understandable, that you are not happy with your result. Your outcome is not what usually can be expected from a neck lift.   I think by perfoming a full neck lift one can smoothen and correct your neck while creating a nice jawline at the same time.  Sometimes it makes even sense to include the lower face or to combine a necklift with a facelift since anatomically and aesthetically the face and the neck can be considered a unit. However, this would be a discussion for an in person consultation with your surgeon. Have a consult with a plastic surgeon whose focuses on the face, and I am very positive you will be able to obtain the result you aimed for in the beginning.

Richard G. Schwartz, MD · Answer

Based on your photos, I think the most likely explanation for the depression just under your chin is removal of fat in that central area.  It is also possible that the platysma muscles may not have been adequately tightened in the front of the neck and are sagging off to the sides.  Without knowing the exact technique your surgeon used, I can't say more.  Specific recommendations can only be made after reviewing your previous photos, operative report, and a personal consultation to check your anatomy.  However, I think there is hope for improvement with a secondary revision to tighten muscles and perhaps even grafting some fat into that central depression (less likely).

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs. I am sorry that you are disappointed with the result of your neck lift.
To start with, it would help to have a discussion with surgery regarding options for improvement.

The images suggest prominence of the digastric muscles and removal of the fatty tissue between them.

Deep plane neck lift surgery can reduce the size of the digastric muscles and lower part of the submandibular glands and plicate the digastric muscles in the midline to create a smoother contour.

Fatty tissue may also need to be add it in the central part to improve the contours.

Zoran Potparic, MD · Answer

Based on these photos, you should discuss neck revbision with your surgeon. In some cases, second opinion consultation with a board certified lastic surgeon with expertise in face/neck lifts may help to find out about your options. Good luck.

Derek Fletcher, MD · Answer

I am sorry you have had suboptimal outcome. Your photos suggest two or more problems. The depression may be due to over excision of deep fat from under the platysma muscle as well as platysma muscle separation. Do you know if you had a deep plane neck lift? If so, do you know if the submandibular salivary glands were partially removed? A review of your operative report and an in person exam will help determine the cause. You need a revision neck lift to correct the contour.

Nelson Lee Novick, MD · Answer

The "turkey neck" problem is quite a routine one in any active cosmetic dermatology practice. I have personally achieved gratifying results nonsurgically employing robust HA fillers to lift and reposition the sides of the neck so as to minimize the central deformity followed by the use of a more cohesive, low viscosity HA filler for further smoothing the central area and improving both its quality and tautness--i.e. a nonsurgical "liquid" necklift. A healthy dose of "buyer beware" caution is in order when being hawked this or that fraxel or RF devices, as the hard science to support the use of these expensive "bells and whistles" gizmos unfortunately lags woefully behind the heavy marketing and social media hype to promote them. Hope this helps and best of luck.

Brian K. Machida, MD, FACS · Answer

A central deformity usually results from central liposuction with a tightened platysmaplasty in a attempt to tighten the lateral central compartment. The revision surgeon will need to be prepared to reduce subplatysmal contents such as the anterior digastric and submandibular gland. An attempt to re tighten the platysmaplasty along with a lateral SMAS lift will result in a similar deformity. These are not typical facelift maneuvers it’s best to seek multiple opinions to find the right surgeon.