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Vertical Scar on Neck to Remove Loose Skin

Blanchard asks:

I am a 58 year old female with history of weight loss of 135 pounds. I had a very successful abdominoplasty (removal of 10 pounds of skin) and breast reduction with lift. I am scheduled for an arm lift soon and would like to have my loose skin removed from under my neck. My PS tells me there is so much skin there that I would end up with big wrinkles behind my ears so he suggests an incision down the front of my neck. I will be a long incision. Is this normal? I am concerned.

Photo from realself.com

It is quite common to have moderate turkey gobbler deformity or significant loose skin in the neck area after losing weight.  Today frequently, patients who have undergone lap band surgery or gastric bypass surgery and have lost a good deal of weight, 50 to 100 pounds, have resultant moderate laxity to the neck skin area.

Remedy for this particular problem is somewhat complex.  Some surgeons will approach the solution differently.  One good answer is to simply perform a standard neck lift/facelift to significantly improve the neck issues.  This can be performed at the same time as a platysmaplasty which requires an incision in the submental crease which is just behind the chin area and minimally visible.  A large percentage of patients who undergo this procedure in an expert fashion will have resolution of concerns to the neck area, but there is always a possibility of persistent laxity in the neck area.  Staging of the procedure is also a consideration.  Many patients undergo standard facelift/neck lift with submental approach platysmaplasty will not require further treatment of the neck area, but some do and when they do a vertical scar in the neck area, also known as a t-neck, can be utilized and decided upon at that time which is essentially at a later time.  So in essence, a vertical scar is not essentially required or necessary but indeed might be depending on the particular anatomy and circumstance.

David Q. Santos, MD

Seattle Facial Plastic Surgeon

Liposuction is not a Weight Loss Specific Treatment

Photo courtesy of realself.com

MixChick asks:

“I am 2 weeks post lipo I had about 3.5 quarts of fat removed from my waist,love handles,lower/upper abdomen. I had 5 liters of liquid injected into me that day. I weigh a little over my weight before the procedure. I am still swollen and lumpy specially in the abdomen area. I am very concerned about those bulges not shrinking down. I don’t look much different than prior to the surgery. I have the same width and my love handles still look a little aquared like before. Help what should I expect at 2 weeks?”

 

A small degree of weight loss can occur after moderately extensive liposculpture/liposuction.  3.5 quarts of fat is reasonable amount of fat removed.  However, weight loss itself is not the primary goal of liposuction.  The primary goal is to expertly sculpt problem areas and overall improve their appearance.  It is much more important to focus on improving appearance and not to focus on weight loss.  Liposuction is not a weight loss specific treatment.  When dealing with weight loss the best answers of course are specifically related to lifestyle change, diet, exercise, decreasing stress and improvement of sleep patterns.

Lumps and bumps and fullness and even swelling are expected at one week, two weeks and even longer.  What is really key is to be patient and understand that the end result isn’t until weeks and even months down the road.  What you see is what you get more often in the three month to six month range rather than in the two to three week range.  Patience is key and looking in the mirror constantly after seven to 14 days can be a bit frustrating.

David Q. Santos, MD

Seattle Facial Plastic Surgeon
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