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What causes tightness around neck after face lift surgery?

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Dr. Hardik Pitroda

Dermatologist

Practicing since :2010

Answered : 1489 Questions

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Posted on Mon, 4 Aug 2014 in Beauty & Cosmetics
Question: I had a neck and lower face lift over 7 months ago. I still have extreme tightness-like a noose- around my neck and extreme pulling of cheeks and ears. It is miserable. I have had a second opinion from a PS and am being treated BY A PAIN MANAGEMENT SPECIALIST. he HAS ME ON ZOLOFT and NOW CELEBREX He TOOK ME OFF OF TRILEPTAL AFTER 4 INEFFECTIVE MONTHS. I have had MRI AND CAT SCAN AND NOTHING APPEARS TO BE WRONG. Dr's JUST SAYS IT WILL GO AWAY. Some days I feel like I cant go on anymore. I have a stressful job and am single mom to two teens. The choking is especially frightening and makes working very hard. Thanks you
doctor
Answered by Dr. Hardik Pitroda 36 minutes later
Brief Answer:
Revision surgery, BOTOX injection

Detailed Answer:
Hello
Thank you for posting on HCM.
I can understand your concern regarding the tightness after facelift surgery.
Based on your description of your procedure, platysmaplasty was performed in order to give you the best possible lower face and neck profile. The platysmaplasty is useful for creating the chin to neck angle that people associate with a youthful neck. This involves tying together the separation between the two platysma muscles on the left and right side.
Usually after any surgery the reactionary edema due to tissue injury can be the reason for the temporary tightness for initial few weeks. Also, the if the sutures are too tight then you may have that extreme tightness and it takes few months before the stitches are absorbed and the tension is released.
But as 7 months has passed and you still having the trouble, I think the above two scenarios doesnot hold good anymore.
According to me, I think either your facelift and necklift is overdone or there is contracture due to scarring of muscles.
In either of case, I would strongly suggest to have consult with your plastic surgeon.
Excessive tightening over muscles can be loosened up by a revision procedure where the tension is released.
Alternatively, a trial of Botox injection can be given. Botox injection will partly relax the tension in your muscles and thus can be helpful in this situation.
I hope you get well soon.
Let me know if you need any more assistance from my side.
Thank you and take care
Dr Hardik Pitroda
M.D Dermatology
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Hardik Pitroda 33 minutes later
I have had botox injections twice to no avail and I think also kenalog. MY pain specialist suggested injecting anesthesia into my neck? I declined because I am afraid of things getting worse. Should I try that? Also what do you suggest for management of the pain and anxiety itself? I am going to Europe in 2 weeks and concerned about feeling sick so far from home.

thanks
doctor
Answered by Dr. Hardik Pitroda 11 hours later
Brief Answer:
Nerve block is a good temporary measure

Detailed Answer:
Hello again,
Injecting anesthetic agent into your nerve is called nerve block.
It is temporary measure to relieve your pain and uneasiness but considering you are going to travel in coming days its a good option for you.
But later on as you return, I would insist you to plan a visit to your plastic surgeon and discuss in detail about the revision surgery and its outcome.
And little positive thinking and meditation would be of extra benefit anyday.
Hope you will be fine soon.
Take care
Dr Hardik Pitroda
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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