Why Neck Bands can Recur after a Neck Lift, and its Minimally Invasive to Full Surgical Treatments
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- Опубликовано: 27 авг 2024
- More on neck lifting: prasadcosmetics...
For more about Dr. Prasad's background and training, please go to:
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A lady had a neck lift done 3 months ago, with incisions placed behind ears and under chin. She is unsatisfied with the results of the neck lift because of something that appears to be a neck band. After consulting with her original surgeon and receiving confirmation that it is indeed a neck band, she now wants to know what can be done to address it and if she will need a full revision as her original surgeon is in another country.
New York oculoplastic and reconstructive surgeon Amiya Prasad, M.D. reviews her concerns in this video, and explains it is common for neck banding to recur after surgery due to a number of reasons, and how she can consider minimally invasive solutions before a full revision:
1:29 - Dr. Prasad details his background training in cosmetic oculofacial plastic and reconstructive surgery, as well as his experience performing and face and neck lifts in his practice
2:15 - Dr. Prasad discusses how a neck lifting procedure is typically done
2:56 - The challenge of recurrence in neck lifting procedures
3:43 - The various reasons why neck banding recurs
4:12 - Options to address neck banding includes Botox®, suture suspension surgery, and a revision surgery that involves cutting or re-suturing the platysmal band
5:25 - The value in first doing a minimally invasive approach to correcting the issue
5:50 - Dr. Prasad’s recommendation
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I'm a board certified Plastic and Reconstructive Surgeon. I came upon your video. I think you are spot on with everything and greatly appreciate simply hearing another cosmetic surgeon explain things without pushing gimmicks and unfounded theories.
Hi Dr.,
Thank you for your comment. I really appreciate another medical professional sharing their perspective with our viewers.
Your videos are always so informative!
I'm glad you find the videos informative, Monique Phillips! Thanks for watching!
I do have some more recent videos about neck rejuvenation, for your reference:
ruclips.net/video/HKM7MGh80RM/видео.html
ruclips.net/video/S210_81tHlE/видео.html
This is Exactly what I a experiencing, Thank you for your thoughts and suggestions, I should have gone to you!
You're welcome, GIMMINNY CRICKET. I'm glad you found the video informative, but I'm sorry to hear that you had your own issues with recurring platysmal bands.
That happened to me as well. Only one band started showing less than a year after surgery. It’s been 3 years and the other band is still not showing. I had it done in Orange County by a top plastic surgeon.
Hi Rhonda S,
Sorry to hear about your problem. Did you have follow up appointments after surgery with your surgeon, where they assessed your results after healing? Close to final results are observed at about 6 months after surgery, which is when I usually take before and after pictures of my patients. I hope this helps you.
@@AmiyaPrasadMD I don't live there, so no i didn't fly back for follow up. But great news is I just had fractional laser last week and I can't see that band now. Don't know how long it will last but a pleasant side effect.
I'm glad you were able to resolve it, @@rhondas3017
@@rhondas3017 Rhonda...could I get some more info about your fractional laser procedure? Did you get the ablative kind that burns the top layer of skin or just the non-ablative kind? Did they just do the neck area only and did this tighten the skin enough so that the bands no longer protrude or are noticeable? This is depressing to find out that no matter what kind of procedure you have done, the bands may re-appear anyway!
Very informative.Thank you Doctor.
You're welcome, Abc Abc! Glad you found the video helpful!
Interesting. How long does it typically take to see the muscle separating again? Can it happen in three weeks or three months? I'm almost 4 weeks out and after the third week I started noticing the curve where the neck and chin meet. I thought I'd have more of an angle and I'm wondering if its swelling still or the platysma starting to hang like before. I still do have quite a bit of swelling including the pouch under the chin....
Hi StarSpun Enterprises,
I can't tell how long it would take for the muscle to separate without seeing your results, and knowing details of your surgery. What did your doctor say during follow up?
This happened to me. I had a deep plane face and neck lift in January of 20. When I returned for a follow-up appt in April it was clear that I had a sagging of skin issue once the swelling had fully dissipated. My surgeon has suggested making an incision under my chin to deal with that pesky platysmal. I also just had Laser C02 to correct lip lines and to improve the appearance of the nasolabial. The outcome has been problematic with redness that just won't quit. My surgeon isn't overly concerned at this point - i am 24-days post procedure - but he doesn't have to apply concealer every day to a wide area around my mouth and chin that I never had to do in the past. So I'm not the happiest resident in the campground shall we say. I still have trust in his abilities. He is a talented surgeon, as my husband is a talented mechanic, but no-one's infallible.
Hi@@denisepaulsenful,
Sorry to hear that. I can only offer a formal consultation for a second opinion, if you want to see what your options are. This would require a physical examination in our office, and a consultation fee that can be applied to the cost of corrective procedures in our office. I hope this helps you.
Hi,Dr Amiya Ihad thread lifts done in my neck area in 2018 for creepy skin,I Had no neckbands or sagging ,now I'm left with neckbands and a bit of sagging as the results of thread lifts.In your opinion what do you think is best a necklift or botox?Thankyou
Hi@@taniacassar5106,
I have to perform a physical examination to determine what's best for you. A suture suspension is a limited neck lift where it's not just the skin that is lifted and tightened, but the soft tissue and muscle as well, so it is better than a threadlift, but not as extensive and invasive as full neck lift as skin is not excised. I hope this helps you.
Would a thread lift address this? What is your opinion about thread lifts in general?
Hi Barbara Verikios,
Thread lifts may help, and last for a few months, or a couple of years depending on the person, and how the procedure was performed. However, I generally don't recommend thread lifts as they are limited to just the skin. Suspension suture is like a neck lift, but without opening up the face, and it is anchored to deeper tissue, not just the skin. I hope this clarifies things for you.
Hi Dr Prasad I had neck lifts done nov 2018 my neck is a 90 degree angle. and I didn't have neckbands All I had was a bit of crepy skin..My plastic surgeon suggested thread lifts to pull the skin upwards,instead I ended up with neckbands and a bit of loose skin .Will this reverse over time,or should I think about having botox or a necklift?Thankyou so much.
Hi@tania cassar,
I have to perform a physical examination to determine what's best for you. A suture suspension is a limited neck lift where it's not just the skin that is lifted and tightened, but the soft tissue and muscle as well, so it is better than a threadlift, but not as extensive and invasive as full neck lift as skin is not excised. I hope this helps you.
I’m concerned with any story that starts out with ‘I had my surgery in Mexico…’ 😢
Hi E Chase,
While there are good surgeons around the world, if their patients need to follow up after they've returned home, it becomes a problem, so they may need to see a local surgeon anyway. The follow up process, and in some cases dealing with complications, makes medical tourism more challenging than they initially realized.
This has happened to me and was the reason I had the surgery. I tried Botox in the bands and it barely helped. I will be six months healed in
September and will be seeing my surgeon. What can I sat to him, I'm afraid of insulting his work, the facelift itself is amazing.
Hi @123gozane,
Botox does not always relax the platysma enough to make a difference. Keep in mind that it's not likely your doctor's fault, but the limitations of Botox for this condition, which he will understand as a professional. I suggest you discuss the possibility of a platysmaplasty to get the result you want. I hope this clarifies things for you.
I just had the same conversation with my surgeon and he emphatically agreed with me. I almost cried I was so relieved. I told him how sad I felt to complain about his work and he was very kind and supportive. He’s doing a revision neck lift in a couple of months for a modest fee (to cover the operating room etc). It made me glad I selected a surgeon based on the advice: go with someone you feel you can work with if things go awry. He’s not a celebrity surgeon and I don’t look 20 years younger..but my surgery came out well, he’s fixing what he can, and he’s a wonderful human being and I trust him.
Dr Prasad, thank you for stating outright things don’t always go perfectly and it’s ok to talk to your surgeon. This honesty in another RUclips plastic surgeon was what encouraged me to go back and speak to my surgeon about my disappointment in my neck outcome after face and neck lift last year. He was very professional and supportive and kind, and emphatically agreed with me. He’s doing a revision necklift with incisions behind the ears and likely a larger incision under the chin to eliminate some of the excess skin. Frankly it’s mostly skin at this point!
You're welcome,@@treasurechest123. I'm glad you worked things out by following up with your doctor, and I'm even more happy you have a great rapport with your doctor so you can work together to improve your results. Best of luck with your future procedures.
Thanks for the video. I have heard a Doctor say that one downside to platysmaplasty is that it leaves a scar/bump under the chin that makes shaving inconvenient for men. Is this true and how do you address this shaving inconvenience issue?
Hi Raul Tennis,
It would depend on several factors, including how the incision was closed, thickness of the skin, and density and thickness of the beard. I hope this helps you.
Lasers might help with improving the texture of the scar.
I had this same problem after a neck lift in 2016. My neck looks almost just like this picture you posted of this lady and I hate it. I am going for a consult with Doctor Greg Mueller in Beverly Hills. He said he invented something that can solve the issue called myellevate. It is a type of suture suspension that you recommended. I hope it works. I tried everything else. Nothing works and several doctors rejected me on revision neck lift. One told me if I try another surgery I may end up with a unicord. I have been rejected by many doctors who say neck bands are too difficult to get rid of and that I should just give up. This is very discouraging. I would do anything to get rid of these bands. Do you recommend suture suspension plus full platysmaplasty revision? I am thinking of asking him to do both. I am confused if I should be asking for an extended deep plane neck lift revision plus cable plication or not. Someone told me that is what I need. Keep in mind my neck looks exactly like this lady you posted. I already had several consults and so far no luck. Most doctors prefer to send me away and say sorry I can't help you or I can try but I doubt it will work. They say neck bands always come back. I would pay if someone could guarantee results but so far nobody will take on the challenge.
Hi Farah's Mirage,
I hope you understand that a proper second opinion involves a physical examination of your neck before I can give it, so I can't recommend specific procedures for you without an examination. While I don't turn away patients because of the challenges of treating platysmal bands, surgeons can't guarantee results because surgery and medical care are not household goods that can be guaranteed. We are dealing with individual people, and people have a lot of variables that can affect their surgical results, such as their anatomy, and their own behavior in aftercare, and recovery.
I would be happy to see you in consultation for a proper second opinion. Consultations are by appointment only, and can be arranged by our offices to be done remotely on a one-on-one video call on Skype or FaceTime. Consultations do require a consultation fee, but the fee can be applied to the cost of treatment.
Our offices are located in Manhattan, New York City which you can call at (212) 265-8877; Garden City, Long Island at (516) 742-4636; or Vienna, Virginia at (703) 356-1336. You can also reach us through www.prasadcosmeticsurgery.com, www.puffyeyes.com, or www.eyelifts.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.
I am a year and half post op from a lower face and neck lift and I'm still experiencing uncomfortable pulling/tightness from ear to ear. I've seen my surgeon twice and also an ENT at his suggestion following the procedure and no one seems to know why I have this outcome or what to do about it. We've tried injecting botox and it doesn't help. The skin itself is not super tight, it's underneath the skin that the tightness is occurring. Am to expect this to be this way indefinitely or will it relax over time? What options do I have for relief??
Hi Kristi Richards,
Sorry to hear about your problem. I hope you understand that a proper second opinion requires a physical examination, so I would have to examine your face and ear areas before making specific recommendations for you. If you can't see us for an examination, you can see a local surgeon with your medical records of the surgery. I hope this helps you.
Dr looks so young
Thank you for the compliment, mo Bi! Much appreciated! :)
Can I have your hair? lol. So healthy looking.
Thank you for your kind words, Frances Walker!
How many units of botox should be use as maximum?
Hi @laly6980,
Individual patients have their own baseline for units. What I do to set a baseline for new patients is have conservative application done first, then it two weeks when peak effects have set it, I observe results to see if further enhancement is needed. Additional units administered two weeks after initial treatment is how I establish the baseline for the patient. I hope this clarifies things for you.
@@AmiyaPrasadMD Yes, thank you 😊
You're welcome,@@laly6980
I think this has happened to me too. Four month post and either the bands are coming back or skin laxity. Can my surgeon tell by examination if the bands are coming back? I was thinking that the skin was not tight enough but maybe this is the case. She did cut under my chin
Hi Pamekay,
Yes, an examination can determine if there is laxity in the platysmal bands. I hope this clarifies things for you.
Thank you
You're welcome,@@pnevlud
Wow. Is there a ballpark on how many units of Botox would be needed? In this case, it might be better to see a surgeon that charges “per area”.🤔
Hi ksero1000,
The individual reactions to Botox vary, but the average dosage depends on the area. What we do to set an individual's baseline for Botox dosage is do the average dose for the area first, then see them again in two weeks to see if additional enhancement is needed. We record Botox dosage for every patient so we can use it for accurate treatment when maintenance is needed in the future. I hope this clarifies things for you.
Amiya Prasad, M.D. hi! As someone who has used kybella. I fear (based on realself reviews) that the material may migrate & affect my neck, and along with aging cause this problem to happen to me. It looks like a costly problem to have with the short-lived results of Botox. I wish I thought of that possibility of neck laxity and bands before I opted for kybella. Thank you.
Yup I’m now doing Botox 🤦♀️ more $$$$
Hi Pamekay,
Botox can be useful in relaxing the platysma muscle, making it less prominent. but for an unbiased treatment recommendation, it is best to consult a surgeon who can do both Botox injections, as well as platysmaplasty. I hope this helps you.
@@AmiyaPrasadMD but she did do a platysmaplasty when she did the neck left in March 2021 scar under chin 🤦♀️ if we do another one what’s the chances they will come back again?
Hi@@pnevlud,
I would need to examine the neck. It is not unusual for platysmal bands to sometimes become prominent again soon after surgery, which is why follow up appointments with your surgeon, and discussing their policy on further enhancement if regression happens soon after a platysmaplasty. I hope this helps you.
@@AmiyaPrasadMD it does and I have been back many times for other facial treatments and Opus she said if three Opus treatments don’t tighten the neck skin enough to reign them in there may be a small procedure she can do as a follow up. Would you happen to know what small procedure she might be thinking about? What would you do about them?
Hi@@pnevlud,
It's not clear, but it could be limited lift, tightening the platysmal bands, or suture suspension. I would need to examine your neck before making a specific recommendation. You can refer to these videos about different neck procedures:
ruclips.net/video/S210_81tHlE/видео.html
ruclips.net/video/HKM7MGh80RM/видео.html