Platysma tightening is the key!

It sounds like your facelift did not adequately address the platysma. The platysma is the muscle that creates the neck contour. As you age, the muscle splits into two parts, one on either side of the midline. The free edge of the muscle sags and causes the turkey gobbler that makes you look old.

Many people think that the cause of the turkey gobblers is excess skin. This is only partly true. Excess skin can make a neck look old but typically an early recurrence of the neck folds after a facelift is the result of inadequate tightening of the platysma.

If what I am saying sounds correct, then what you need after last years surgery is a simple platysmaplasty, which requires a 1 inch incision under the chin - not the vertical scar that you describe in your question.

Good luck!

Robert M. Freund, MD

Hello Imogene,

Based on your description of things it sounds as though you would benefit from a neck lift or platysmaplasty.

I am assuming that the results from your faclift are still satisfying to you since it has only been a year.  That means your jaw line is smooth and your lower third of the face has a more youthful appearance.

Think about your anterior neck as the area over your throat and under your chin.  This area is covered by the platysma muscle.  If you can see muscle bands on your neck then this means that the platysma muscle is not connected in the middle and the bands you are seeing are the edges of the muscle.  During a platysmaplasty excess fat is removed and the muscles are sewn togther in the middle (this is done much like the way an old fashioned corsett is tightened).  Some extra skin is removed but unless the skin is very weak and "crinkly" then not much skin removal is needed.  If the skin is weak and "crinkly" then addtional incisions can be made behind the ear to pull up, remove and tighten the skin. 

The incision for the platysmaplasty can be kept quite small (1.5-2cm) and can be easily hidden in natural creases (these creases run parallel to your chin and do not need to go down the throat area).

A neck lift or platysmaplasty can be readily performed with local anesthesia and offers long lasting and satisfying results.

It is also important to address the quality of your skin with non-surgical approaches to get yourself the best results. 

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