How do you correct an over liposuctioned "turkey neck"?
I am very unhappy with the liposuction of my "turkey neck". I look older now than before. I have a ditch under my chin, bands, wrinkles & loose skin I did not have. I am trying to be strong. I don't look in the mirror much. I need this fixed but I am afraid. I trusted my doctor but he let me down. I am ready now to move forward to fix this mistake. Please help. Thank you. Nina
Without a picture to evaluate you, it is very difficult to state exactly what your problem is and suggest a way to resolve it. The 2 most common problems after liposuction of any area, not just the neck, is over removal of fat and only removal of fat when tightening of the surrounding tissues was necessary. The "ditch" under your chin may indicate that you have had too much fat removed. If this is the case, some correction can be made by reinjecting fat into the area. However, the "band, of course, and loose skin," makes me think that you also needed a face and neck lift to remove the excess skin and tightens the muscles. Seek a plastic surgeon (which you can do through this site) who specializes in facial rejuvenation and fat grafting. That way they can evaluate the whole problem and suggest a reasonable solution. Make sure, before you agree to anything, that you have discussed exactly what you wish as well as determine what you should expect from whatever is done.
Excessive removal of fat of the neck in the subcutaneous and sub-platysmal fat can result in depression of the sub-mental area. Also "turkey neck" may imply excess skin and loosening of the platysma muscle. So the problem could be removal of too much fat, then in that case fat transfer can be helpful. When the muscle is loose and the skin is loose then a neck tightening procedure is needed along with fat transplant if needed.
The decision for what is the most appropriate procedure needs to be done after examination and review of the operative note of the previous surgery
Your description sounds like too much fat was removed, especially directly under your chin and did not correct the loose muscle and skin which you had. The best correction to improve the contour of your neck is a neck lift/face lift where the remaining skin and fat of your neck are elevated, the bands of platysmal muscle of your neck is sutured together in the midline and by doing so this will help correct or possibly completely correct the "ditch" below your chin. The neck contour is further smoothed by tightening the platysmal muscle near your ear. The skin is then smoothed over this newly created contour and the excess removed. This should correct the bands and the excess skin. I recommend the suturing of the platysmal muscles to fill the defect below your chin because this tissue has an excellent blood supply and a very high chance of all the volume remaining while fat grafting is not predictable as to how much volume is retained, especially if the fat is placed into an area which has prior surgery. See a board certified plastic surgeon to discuss this and ask to see their before and after photos to see their results on patients whose necks are like yours.
There are a number of reasons that the contour of the neck is not as ideal as you would like: over-suctioning of the fat, excess fat removal in one or two areas producing depressions, separation of the neck platysma muscle which was not addressed, loose skin that could not be corrected with liposuction alone, or a combination of these.
The best correction would depend on the anatomical findings and may include: fat grafting, tightening of the platysma muscle, neck lift, or neck and lower face lift.
Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without seeing photos, examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California