Mark Johnson, MD, PhD
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Mark Johnson, MD, PhD
Cosmetic surgeon | Views: 43372

Friendname: DrMarkEJohnson
Business Name: Nouveau Jeunesse Rejuvenative Medicine
Website: findnewyouth.com
Location: 7131 W Deschutes Ave, Ste 101
Kennewick, WA 99336
United States
Telephone: 509-736-9989
Languages Spoken: English

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Ask An Expert > Mark Johnson Message Board > HELP - had a SMAS with a submental platysmaplasty 6 months ago. I developmented inrregularities (dents and divots) about 5 days post-op.
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HELP - had a SMAS with a submental platysmaplasty 6 months ago. I developmented inrregularities (dents and divots) about 5 days post-op.
No liposuction was done. The irregularities were localized to the center of my neck and everyting felt support. I've had a difficult recovery. As a result, my PCP sent me to several doctors including an ENT. The ENT pressed hard on my neck and I felt something tear on the left side my neck and noticed a loose pocket of skin on the left side of my neck.

I believe as a result of the exam, the plastysmaplasty has "spread out" (including the dents and divots. I feel a downward tugging sensation whenever I touch the left side of my face directly in the spot where the loose skin is on the left side of my face. It makes any jaw movement very uncomfortable (it seems to be worse at night when tryng to sleep). The divots appear to be increasing in size and depth and the skin is extremely thin. I did not have this sensation when everything was supported. My ears/checks feel supported and the area of my neck below the divots feel supported, just not the area under my chin and sides of my neck.

I'm desperate for answers. The pulling and tugging sensations are VERY uncomfortable. My skin feels like it may rip at times.

Since I am only 6 months post op and am having a difficult recovery, I'm not sure I have many options. Are fillers in the area an option. If yes, what type would work best? I've heard some mention of fat grafting, but know this produces somewhat unpredictable results. Further, it is surgery and I'm not sure I'm ready for more major surgery at 6 months post op.

I've met with my PS (well known in this area) and he says there is nothing he can do.

I REALLY am looking for answers and appreciate any HELP in correcting the situation.

Thank you

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Plastic surgeon
Baltimore, MD
United States
View My Professional Profile
Facelift  October 1, 2012 12:23 PM

You seem to have had a complete skeletonization of the neck. That is excess removal of fat.Skin is stuck causing the deformity.
The treatment is surgery, after six months there will be no further improvement.

Plastic surgeon
Ellicott City, MD
United States
View My Professional Profile
Neck lift  October 1, 2012 1:42 PM

I am sorry you are having a difficult recovery. Based on the photos, it seems that you have alot of scarring in the area and why that occurred is difficult to determine without seeing your pre-op photos, op report and examining you. It may have been too much fat removed or it could be a seroma or hematoma after surgery or just abnormal scarring. So what can be done now? Well some options may be steroid injections into the firm areas, aggressive scar massage, fat grafting, further surgery, or waiting another 3-6 months. I would seek another opinion from an experienced plastic surgeon in your area. Hang in there, things usually get better with time. Best of luck!

Plastic surgeon
Miami, FL
United States
View My Professional Profile
  October 2, 2012 3:49 AM

The posted photos are ONLY of the extended neck, better would be frontal full face/neck. Over the internet very hard to advise. But my GUESS is either you had neck lipo or too much resection of neck fat. Treatment is a very difficult issue. Best to seek IN PERSON many second opinions.

Cosmetic surgeon
Kennewick, WA
United States
View My Professional Profile
  October 3, 2012 6:18 PM

I agree with my esteemed colleagues, notably Dr. Dauria. Examination in person is a necessity. There may be a role for stem cell augmented fat transfer to select areas to improve appearance, as well as the other options Dr. Dauria laid out.



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