Will A Tracheal Shave And A Submentoplasty Fix My Neck Problems After My Facelift?

Q: Dr. Eppley, I had a lower facelift/necklift that left me with a prominent (at least in profile) Adam’s Apple and showing some platysmal muscles under the chin probably because of lipo done in that area years ago. I’m wondering whether a tracheal shave would be helpful and possibly a resuturing of the platysmal muscles directly under the chin to smooth that area out? Thank you.

A: I suspect that the reason you have the submental hollowing is that either fat was liposuctioned from that area and the platysmal muscles not sewn together (unlikely) or the subplastysmal fat was directly excised and the platysmal muscles that were sewn together separated sometime after surgery. (very likely and most common reason) The thyroid cartilage has become unmasked due to the muscle tightening above it (it is carried down to it but never can be done over it or below it).  This pulls the muscles and overlyng neck skin up and back, creating a much better cervicomental angle but not exposing the prominence if the thyroid cartilage. I have seen this complaint from necklift patients numerous times and it is usually thin women that are most predisposed to this potential aesthetic trade-off problem.

I would agree that the best approach is a direct tracheal shave and a limited submentoplasty using a z-plasty approach to overlapping the platysmal muscles. (to lessen the risk of a recurrent submental problem) This is a far easier procedure to go through than your original facelift with a very limited recovery.

Dr. Barry Eppley

Indianapolis, Indiana