Best Treatment for Residual Neck Laxity Post Necklift Surgery

Five months ago, I had a facelift and necklift with plastyma band plication performed by a highly recommended skilled PS. The bands in my neck are still quite prominent and there is still a significant amount of skin laxity. Not the results that I was hoping for. I did express my concern. My PS suggested Botox, and other non-invasive tx rather than a revision. My research suggests that these treatments are less than optimal. What treatment or surgery would be give the best results?

Doctor Answers 5

Improving a neck lift result

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You are correct that Botox and non-invasive treatments for neck bands are only temporary and you should have a second opinion to see if further surgery could tighten loose bands in a better fashion.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

neck bands after neck lift

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Dear patient from San Francisco, CA
I reviewed your face and neck lift after photo. It appears that your platysmal band is more prominent on the right side and the horizontal lines are still present. It would be helpful to see your before photos as well. If you had a Baker type III or IV neck, this might be as good as you can get. Because there is limited amount of tightening of neck is possible during neck lifting procedure. Over tightening may cause skin necrosis behind the ear area. However, if you had type II, the results should be better. In regard to Botox treatment, it is temporary. You may need a touch up in 6 months. Talk to your surgeon again for his advice. Good luck.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Neck lift revision may be best, but not yet.

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Believe me, your surgeon is probably (almost) as bummed-out as you are that your result is not up to your or his desired results. Sometimes it's hard to admit that we fall short of your (and our) goals, especially when it comes to talking about how much it costs and who is responsible for payment for any type of revision or touch-up surgery.

(In our office we have this all spelled-out prior to surgery being performed; there is less anxiety on everybody's part when this rare but unfortunately real situation comes up).

Ocasionally, some surgeons are unwilling or seemingly unable to admit that things haven't worked out as planned. Most of us really want our patients to share our shortcomings wiht us, rather than some other surgeon, so we can address the concern and "fix" the problem as best as we can. But if you find out your doctor has a Mr. Hyde personality, seek additional consultation elsewhere with a  board-certified (American Board of Plastic Surgery) experienced, plastic surgeon who can give you good advice and honest answers.

By the way, five months is still a bit early to consider a revision. Waiting longer will not make things suddenly get better, but it will make any subsequent surgery safer and with more predictable healing and results, rather than reoperating when scars are still immature and firm.  Good Luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

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Post facelift skin and band laxity.

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Often the surgeon cannot make the skin or bands as tight as he would like due to amount of skin and how far he would have to come down your hairline. You might want to get a second opinion from another experienced facelift surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Neck bands after neck lift surgery

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Sometimes a revision is in order and the bands have to be plicated and divided inferiorly to achieve the desire results.  Loose skin can be lifted as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.