I am 39 and have decent skin tone and texture but hereditary Platysmal banding...no smoking at all and a positive history of sun exposure but no sun in the last 5 years (religious use of sunscreen in 7 years).
I have had several consults with surgeons (board certified plastic and facial plastic) regarding my neck. I have platysmal bands that go down from chin to my scapular bone and have had Botox 3 times in this area with no result and Total FX (conservatively done).
No improvement with Botox with three attempts by two surgeons (despite their incredible credentials). The two surgeons also didn't consider me a face lift/neck lift candidate and don't do isolated neck lifts in their practices due to inconsistency of results....therefore they won't work on me because I'm not a face lift candidate.
Can someone suggest another option for my platysmal bands besides a neck lift or Botox?
Platysmal bands occur because of a diastasis of the midline platysmal muscle and a laxity of the submental fat. Serious thought should be placed into performing the gold standard for correction, neck lift and platysmal plication, rather than other non-invasive procedures that do not address the muscle.
In my practice, I adhere to surgical guidelines to correct problems that are surgical in nature. Performing lesser treatments lead to dissatisfied results.
Neck bands are usually a combination of three things:
1. Loose skin of the face and neck
2. Loose muscles
3. Loss of volume of the face
The reason you did not have success with minimally invasive tightening treatments and Botox to the neck muscles lies in the weaknessof those treatments.
Botox relaxes muscles. It does not tighten them.
Radiofrequency treatments or fractionated lasers offer only a very small amount of permanent tightening, much less than what is typically bothering patients.
With proper medical clearance and optimization of the medical status, most patients can have a facelift, even if it performed under light sedation under the watchful eye of a board certified anesthetsiologist.
The difference between a neck-only lift performed from behind the ear and a facelift is not that much in experienced hands. A facelift/necklift with platysmal tightening is from your description the right procedure without respect to medical issues.
An experienced surgeon will perform the procedure quickly and with minimal blood loss. A novice will take a great deal of time and incur a large blood loss, a physiologic burden the patient must carry.
If several experienced surgeons do not believe you are a candidate for surgery for medical reasons, this is something to listen to. While you will undoubtedly find somebody to perform surgery on you who does not have concerns about your underlying medical conditions, this is obviously to be avoided.
You may have a decent result from having just a platysmaplasty procedure, accepting that this will give only modest results.
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