9 Weeks Post Neck/Face Lift: Neck is Starting to Sag

Sagging skin 9 weeks later can mean many things.  You probably aren't going to have significant tightening after 9 weeks.  The most helpful thing to do is review your before and after pictures and see if you made any progress from you were before your procedure.

There is a saying that after plastic surgery, or vision gets better, and our memory gets worse!  We start to see and notice things we never saw before, and no one can remember what they used to look like.  That is why pictures are so valuable.

You will always have some laxity - if you don't have laxity the result won't look natural.  If you have excess laxity, you might require a touchup or an larger procedure that what you originally chose.  Most facelifts fall into the general category of either a small, medium, or large lift.  Watch the attached video to learn more.

The most important decision you make is the artist/surgeon that you choose - please let us know if you have any additional questions!

The recovery from a facelift is quite variable, with the most important consideration being the quality of your skin before surgery. Your results will evolve over the first six months and I recommend that you wait at least that amount of time to assess your results.  Consult with your surgeon at that time if you have concerns.  You may for instance benefit from laser resurfacing at that later date.  Good luck.

Some level of sagging and settling is normal after surgery and the extent of this depends on the condition of the skin before surgery.

 After 1 year, the surgery is what it will be.  If further tightening is needed, you may consider a laser peel such as a CO2 or YSGG peel.  This can tighten up some of the superficial skin folds and lines.  The treatment is mild though, so don’t over treat the area.

Although the majority of the swelling after facelifting resolves after a few weeks, the remainder will resolve over three to six months. During this time you may notice fullness in some areas, and relaxation in others. There is alot of healing that takes place under the skin as well. For this reason you will notice fluctuations as well. Be patient, feel free to discuss your concerns with your doctor, as I am sure they are as concerned about the final result as you are.

Agree with the posted answers this far. It is way to early for the skin to be sagging. It is likely that not enough of the deep tissue was tightened. on the other hand it is very important to know where you started. If you had a very heavy neck or a very lax one it may be that you are much better but no perfect. In these sort of cases it is perfectly acceptable to have a small tuck done at 6 months post-surgery. I would hope that you have upcoming follow-up with your surgeon and that they will address this with you.

If your facelift is failing after 9 weeks it is likely the tension was placed on the skin instead of the undersurface of the face or SMAS. The skin is like a rubber band and will rebound without the chance of re-tightening. This is common for the easy and minimal facelift techniques. You may be looking at a secondary facelift in the future. Sorry. Dr. Trussler

To answer your question directly, swelling is present immediately after surgery, and is gradually reabsorbed as time goes by. Final results are not seen until 6-12 months post-op, which is why many if not most surgeons ask our patients to wait that length of time before requesting (or us recommending) revisional surgery. As your swelling goes down, the skin softens and relaxes, and fine surface lines and wrinkles may reappear. These are appropriately dealt with via peels or laser resurfacing. Skin does not tighten as time goes by, but as swelling is absorbed, appearance does indeed improve.

But, if the degree of swelling was great, or the degree of skin elasticity and natural collagen content low, or the amount of skin removal and tightening suboptimal, or any combination of the three, you may begin to notice skin laxity and crepe sooner rather than later.

Since the neck is the lowest area of the face that was operated on, gravity tends to make this area most susceptible to the effects we are discussing. An elastic chin strap worn day and night for the first week helps to minimize the collection of blood, fluid, and excessive swelling in this sensitive area, and I have my facelift patients wear it at night for a second week. For the first 3 weeks I recommend NOT laying flat at all, for even a few minutes, to reduce swelling that naturally occurs when your face is at the same level as your heart. Put a sofa cushion beneath your mattress rather than trying to "sleep on 2 or 3 pillows" because each of us rolls and pushes pillows aside, allowing the face to swell. Avoiding nausea right after surgery (retching and emesis) helps avoid excessive swelling and bruising, and use of ice bags if your surgeon allows this, are all that patients can do to help themselves get the best result possible.

The rest is up to the surgeon (and what he or she had to work with in the first place)!

It is not normal to be drum tight with a properly done facelift.  A happy balance with aesthetic improvement is the goal of an appropriate facelift rather than the mac-1 look.  Facelifting is not a substitute for improving the quality of this skin which is better handled on the face with chemical peels and laser treatment.  Sagging in the neck can occur even with a well executed facelift.  Occasionally is arises for early activity right after a facelift.  If the sagging is more than desired, this sometimes becomes the basis for early revisional surgery for further refinement of the result.  In my office, this drive for a perfect aesthetic results is recognized.  However, perfection is not a realistic goal for cosmetic surgery.  Generally we charge for these types of revision.  Your surgeon is likely to have a similar policy.

During every pre-surgery office visit for rejuvenation surgery, I talk to my patients about what to expect immediately after surgery, as well as what to expect once the healing is complete. All patients need to know about the phases of tissue healing: early swelling, followed by stiffness, which gradually softens to a natural feel, over about 90 days after surgery. After all the healing is done, every one will notice some laxity. This represents the true, end result of the surgery. Often, it is at this time that I recommend laser skin resurfacing  with a fractionated Carbon Dioxide laser to repair and minimally tighten the skin envelope. Depending on the person's age, some of the new skin-tightening systems may be beneficial.