Neck pleating, chin is a mess, 4 months after neck lift. (photos)

Question

See pictures. This area looks much worse now than it did 2 weeks after surgery (except that the bruising is gone). Will this area soften/relax? I'm very self-conscious about it. From a profile view, there isn't much improvement from a pre-surgery profile view. I'm 60 years old. I've been massaging gently twice a day with cocoa butter per PS's instructions. My last checkup was at 3 months. She thinks everything looks fine. I'm not scheduled to see her again until month 7. Thanks in advance.

Christopher T. Maloney Jr., MD · Answer

Thank you for your question and for attaching photos. It certainly does appear you will need a revision, however I would wait another 2 months (6 months from surgery) to do the revision. You probably had some excess fluid after surgery and this combined with the scar tissue has left this area that needs to be corrected. Best of luck.

Jed H. Horowitz, MD, FACS · Answer

I am sorry to read of your concern. It would be helpful to know more about the surgical techniques applied during the procedures as you may benefit from additional treatment to better correct your concern. Nevertheless, it's best to wait at least 6 to 12 months depending on the reason for a #revision.
Though recovery from such procedures varies from person to person, patients are generally presentable within three weeks from surgery.  Also, wearing a #compression garment may be suggested the first week and then nightly for up to six weeks. Your incisions will go through many changes before seeing the final result of your procedure. Swelling will also continue to diminish.Thus, you must be patient. The #scars from a #neck lift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the procedure will become apparent and the real result will be seen. If during your healing, you have any concerns, it is suggested to call your board-certified surgeon or their medical staff and discuss those #concerns

Deborah Sillins, MD · Answer

i agree those bands do not belong there after neck surgery. I am not sure if see grab to much of you muscle and try to tighten it. you definitely need a revision to smooth this area out

Brian K. Machida, MD, FACS · Answer

Its best to wait at least 6 months after surgery before considering any revision.  You can see adhesions like this after a fluid collection.  Because it is more apparent with an upward tilt, it might be within the muscle as well.  A revision might be necessary.

Jason Emer, MD · Answer

I recommend following up with your Doctor for a formal evaluation and after care recommendations. It can take up to 6 months to have your final results with a neck lift. To improve your final results, I recommend a combination approach with thermage/venus legacy and Kybella/Ultherapy. I recommend getting a formal consultation with an expert. Best, Dr. Emer

Parker A. Velargo, MD, FACS · Answer

While you will see some improvement with time, your outcome looks like you will require a revision procedure for optimal results. It appears you only had a submental (under the chin) approach, which is a common cause for these sorts of irregularities post-op. Seek a second opinion with a board certified facial plastic surgeon or plastic surgeon. Good luck!

Mark Glasgold, MD, FACS · Answer

4 months is still early in the healing process and this would be a typical appearance if there was a seroma or collection of blood postop.  this will continue to soften and improve for up to a year.  steroid injections can be used to help the hardness resolve more quickly
if you are dissatisfied with the appearance after the hardness resolves of if the hardness does not resolve a direct excision is often a good solution.

Christian Subbio, MD · Answer

This does not look normal, and you need closer follow-up than four months.  Things should improve somewhat with time, massage, and may be other modalities such as ultrasound heated massage, but I suspect that some kind of revision will be necessary.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Laxmeesh Mike Nayak, MD · Answer

This pleating is at its worst now. I would recommend continuing with your surgeon for dilute steroid injections and massage.The pleating will soften over many months. When this process has finalized, at a year or more, a revision may be indicated, but I expect the final result can still be good in the hands of a patient expert.Trying to perform a revision earlier than that will create a much worse final result.

Richard O. Gregory, MD · Answer

This condition probably results from a lack of removal of skin. The skin has adhered to the underlying muscle without much shrinkage. Although this will improve with time it is unlikely to be satisfactory and therefore I would advise revisional surgery which would include a facelift. In most instances whether addressing issues in the face or neck a standard facelift incision, possibly including a sub mental incision under the chin, is necessary in order to correct sagging of the deeper tissues as well as remove skin. Postoperative results such as these most commonly follow a procedure done by someone who has little experience or training. Surgeons who claim to be plastic surgeons may have little experience or training.

Neck pleating, chin is a mess, 4 months after neck lift. (photos)

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