Revision for excess skin under chin/neck 8 months after facelift? (photos)

The areas of swelling might represent muscle vs fat or salivary gland under the muscle.  In order to tighten the muscle further, it might require approaches from the submental area under the chin, as well as from the sides via a facelift incision.  You can get further tightening this way.  However if it is due to fat or gland under the muscle, it may look better but not totally resolved with a revision surgery, because fat and salivary gland under the muscle cannot be removed with facelift surgery.

It sounds reasonable to go back in there and try to correct whats happened, without seeing you in person, i don't know if only a front approach will improve it, but its possible that it can be improved by taking a look and seeing whether its residual fat or the platysma muscle needs to be redraped and tightened along with the overlying skin. If there is a lot of loose skin, that may also need to be removed, but if you are only 8m after the initial surgery, its unlikely that is the case. 

Thank you for your question.  If you want an L shaped neck you would need to remove the fat, which is normally achieved by neck liposuction.  You would need to completely liposuction the area, before dragging the skin tight.  This would ensure the longevity of the results and achieve a slender neck.  All The Best 

Something as simple as some liposuction on each side may give you the improvement you desire. There is very little if any downtime with this. Your surgeon's recommendation also seems reasonable.Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa Aesthetic Centers

Hello,You're doing the best thing by telling your surgeon your concerns. If he/she feels that it can be improved with an office procedure that's the easiest thing to do. All the best in your journey,Dr. BlaggAustin, TX

I don’t believe that your condition under the chin is redundant skin.  My impression is that a muscle ( digastric muscle) is showing and needs to be corrected with another surgery

It's great that you are continuing to see your initial surgeon as he or she knows exactly what was done in the initial procedure.  These things happen to all surgeons from time to time as the healing process is unique to each patient.  It does seem very reasonable to approach this from under the chin so that direct visualization of the problem can be performed and addressed -- likely you are dealing with a little bit of excess fat, muscle malposition, and/ or additional skin laxity.  Good luck!

The most important thing is that you're working with your original surgeon, who knows exactly what s/he did, and it appears there is some scar tethering there (assuming there was also a neck incision there) that may respond to release and redraping, although the scar may need to be made a bit longer to take in skin at either end.  Otherwise, a repeat tightening approach from the sides (if this is moreso residual/remaining laxity emerging now that swelling is largely resolved) may be necessary, and should be effective (at least it has been in the few early revision facelifts I've treated . . . ) Hope this helps!

Those areas will not likely improve with time and, if there is no underlying fluid collection, likely represent an underdone facelift.  A wider neck surgery is required all the way down to the clavicles to provide a wide area of redistribution of extra skin.  Your surgeon can likely use the same skin incisions to accomplish this.  Good luck!
Dr. Z

The potentially limiting factor is your skin elasticity. Your surgeon knows this best at this point. It would indeed be common to attack this through the incision behind the chin unless your skin is too much for its elasticity in which case it should come out from the sides again. I rarely find that removing skin from behind the chin offers any improvement and, in fact, geometrically would be counterproductive (a squared + b squared = c squared)