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Neck Lift: Better to Cut over Active Platysma Band, or Tie Bands Together? Under the Chin?

asked 7 months ago by Kelsey1
Latest answer by Sam Naficy, MD
Question viewed 401 times
Tags: neck bands, platysmal, technique

In the case of neck "bands", it appears popular technique is to tie bands together in a corset method. I've also heard of a few surgeons who choose to eliminate the platysma portion that protrudes - by excising it. I had platysma work previously, which I believe made my platsyma band more apparent. I am also skeptical that tightening muscles under the chin will not have a favorable effect on the mouth area - may pull it down. What are the risks of removing a very small portion of platsyma?

10 answers to Neck Lift: Better to Cut over Active Platysma Band, or Tie Bands Together? Under the Chin?

+2

Management of neck "bands"

Management of platysmal bands during open neck plasty may be approached several ways. Described techniques include midline suturing of the edges (corset, popularized by Dr. Joel Feldman), Z-plasty, transverse myotomy or myotomies (Dr. Bruce Connell), and others. Use of Botox described (closed), and T-Z direct excision described by Biggs and by Gradinger. Probably other methods as well. Dr. William Little recently presented a series of facelifts without specific... more
Steve Laverson, MD

San Diego Plastic Surgeon
+1

What to do with platysma

The answer is that it depends. Each neck has its only unique anatomy and require one, two, or all of the techniques that you mentioned
Sam Naficy, MD

Seattle Facial Plastic Surgeon

seattleface.com

+1

Addressing platysmal bands in neck and face lifting

Removing part of the platysma is never indicated. In my practice it is not extremely common to manipulate the platysma any more than I do in my routine SMAS-platysma suspension laterally. When it is indicated I prefer to tighten further at midline in a corset type manner and transcet th pltysma low to elevate the cerico mental angle, excision of the medial edges may only be necessary to reduce bulk in cases of extreme laxity but cutting parts of bands out would likely... more
Rian Maercks, MD

Miami Plastic Surgeon
+1

Tightening the neck muscles is the best option. It will not pull down your mouth at all

I have done over 1200 neck and face lifts and can tel you that tightening the neck muscle (platysma) should have little effect on pulling your mouth done, if done correctly. Cutting the platysma muscle is not good in most necks, like 95% of the time. Below is an example of a video that helps to answer this question for you to watch and a link to see more informative videos: see video
Philip Young, MD

Bellevue Facial Plastic Surgeon

www.drphilipyoung.com

+1

The treatment of neck bands has to be tailored to the individual anatomy

Hi. 1) The goal is to have a smooth right angle under the chin. How you achieve that is based on the anatomy. Very seldom is a significant amount of platysma removed. In some patients, suturing together the muscles in the middle works well (the corset approach). In others, the bands have to be divided (not removed) low in the neck to interrupt the "bowstring" effect. 2) There often are other anatomical problems besides bands that contribute to... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

There are a number of different methods to treat prominent bands in the neck, using

Either a surgical or non surgical approach. The bands in the neck are due to muscular activity of the platysma muscle, and can be relieved by cutting the muscle or re-directing the vector pull of the muscle through sutures. Botox or Dtsport, by interfering with the function of the muscle, can temporarily relieve the banding in the neck. The muscle can also be excised or back cut, both of which serve to limit the pull, or banding in the neck. The surgeon can also... more
Michael H. Rosenberg, MD

White Plains Plastic Surgeon
+1

Neck Lift: Better to Cut over Active Platysma Band, or Tie Bands Together? Under the Chin?

Interesting question. With no photos posted in at rest and active contraction of the P-bands very hard to advise. Some also cut and plicate the P-bands as a combination techniques. One risk in excising a small portion of the P-bands is submandibular gland ptosis. Seek in person opinions.
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Neck Lift: Better to Cut over Active Platysma Band, or Tie Bands Together? Under the Chin?

I have performed Face and Neck Lifts for over 20 years and IMHO, you shouldn't get hung up on any one technique. Each plastic and cosmetic surgeon will perform a Face and Neck Lift differently and even use a specific technique in a different manner. IMHO, it's always best for patients to focus on the desired result and then find a plastic and cosmetic surgeon with the appropriate aesthetic judgement, skill and experience to modify whatever technique required in order to... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Neck bands and their treatment.

Removing a part of the platysma bands and suturing the remainder with a back cut is the usual treatment of this problem. Since your's is a revision this may be different and without seeing you or a photo one can't give an accurate answer.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

MACS-lift combined with anterior bands approximation

Dear lady, it would have helped to see which is the degree of platysmal banding you have, and to know whether these bands are dynamic or static. Also which "work" did you have previously on the platysma? My management of the neck usually only involves a vertical lifting of the platysma with a MACS-lift, which I designed in Belgium together with my associate Dr Tonnard. In the cases where preoperative assessment shows that vertical lifting doesn't correct the bands, an small... more
Alexis Verpaele, MD

Belgium Plastic Surgeon

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