Post Face and neck lift - Loose skin under right side of chin/neck area. How can I improve this? (Photo)

Question

I am not happy with extra piece of skin under the (R) lateral side of chin/ neck area and was told it could be submendubular gland and i do not feel this is what this is... i spent alot of money and would like opinions/ suggestions to what this is and how to address it. Thank you!

Chet Mays, MD · Answer

Thank you for your inquiry!   Seeing you in person and being able to feel the area would help determine what treatment could help you to your goal. It is difficult to determine the fullness is without being able to palpate the area.  Schedule an appointment with a Board-Certified Plastic Surgeon to discuss your options.

Robert M. Wald, Jr., MD · Answer

It's difficult to comment on your results without seeing your preoperative pictures and examining you prior to the procedure. With this in mind, this could be a submandibular gland or an accumulation of post op swelling and scar tissue with some loose skin. Massage therapy, possible steroid injections, or a secondary procedure may be indicated. I would follow up with your surgeon or other plastic surgeons in your local area.

Gianfranco Frojo, MD · Answer

This is a prominent submandibular gland, especially adjacent to the over-resected fat in the midline of the neck. The best solution is a revision necklift with partial gland excision.

Michelle Lee, MD · Answer

I'm sorry that you were left unhappy after your surgery! Due to the location of the bulge, it is possible that your submandibular gland is contributing but it could also be a bit of leftover fatty tissue or loose skin. Typically, if it is fatty tissue, this could be corrected via a simple office procedure.

John Michael Thomassen, MD · Answer

You appear to still have some excess skin under the mandible causing a festoon in the neck.  A revision can be done to tighten this neck skin and smooth it out.

P. Alex Montague, MD · Answer

Thanks for your question. It's hard to say definitively without a proper physical exam and seeing the operative report from your surgery to know exactly what techniques your surgeon used underneath the skin. Although it feels like loose skin on the outside, there is likely something anatomic going on underneath the skin and muscle layer. When we do the neck sculpting work during face and neck lifting we often go underneath the platysma muscle to remove soft tissue. There are various soft tissues in this space including fat, digastric muscle, and submandibular glands. So theoretically anyone of these could be the culprit, but my best guess from the picture is that you're seeing the slight bulge of your submandibular gland. Unfortunately, if it is the submandibular gland or even your digastric muscle, no non-invasive treatment is going to improve that. Your best option would be to revise this by going back in to remove the gland or muscle surgically. Removing submandibular glands via this approach is somewhat of a new procedure and many plastic surgeons do not perform this so you would want to make sure you see a surgeon who does this routinely. Hope this helps and best of luck!

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

The images suggest sub- platysma volume, either the digastric muscle or the submandibular gland. The best way to confirm what is the problem would be to have imaging sitting up. This can be either an ultrasound scan or an upright MRI scan. They can both determine the characteristics of the volume that bothers you and will give you guidance regarding the best course of action to address it.

A significant number of secondary necklift interventions are based on removal of either digastric muscles volume or submandibular gland volume or a combination of the two. During the surgery, due to the supine position and the tension applied on the skin it can look like the contours are adequate and it can be tempting to avoid going under the platysma. Unfortunately, sometimes when the soft tissue swelling and tension decreases, the volume left under the platysma becomes apparent.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
We can’t really make quality assessment based on the information included.
 Best,
Mats Hagstrom, MD

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