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Neck Band Re-do After Submentoplasty?

I am 47, someone thin, really good skin tone. In June, I had submentoplasty without the skin incision to remove banding. It looks a lot better than before but I still have two small bands located right at the junction of the cervicomental angle. They do not extend down my neck, they are just in the angled area, maybe about 3/4 inch long. When I clench my teeth, everything flattens out nicely. But when I am relaxed, they are visible. Should I redo the bands, skin incision, fat added? What is the best remedy? Thanks.

Doctor Answers (7)

May not be muscle bands, but "imprinted" neck skin still holding the shape from the prior neck bands.

+3

Hi Tina,   

I read your description carefully, and the one unusual thing that you described was that the two little bands flatten out when you clench your teeth.  This is different from what normally happens when someone already has platysmal muscle bands.  If the person has very small platysmal muscle bands when they are relaxed, the bands can get thicker and longer when the person clenches their jaw/teeth.  This is different from what you have described, which makes me think that botox or a revision of the corset platysmaplasty may not be the right way to go.

  • A Submentoplasty is a mini-necklift, which does not require incisions around the ears to remove skin.  My cut off for performing mini-necklifts is age 45, and if the patient's skin elasticity is poor from prior sun damage, that age may be even lower.  Normally once the muscle bands are flattened out using a corset platysmaplasty, or midline platysmal imbrication, which simply means that the edges of the muscle bands are sewn to each other, this should be a good method to flatten out the platysmal muscle bands which are tenting through the neck skin.
  • As these muscle band stretch out the skin of the neck, the neck skin will accomodate to its new shape.  If a younger patient with good skin elasticity has a submentoplasty, these two skin "imprints" from the muscle bands should flatten out on their own.  However, with sun-damaged skin or skin with decreased fat support and loss of elasticity, it may maintain the imprint of the two platysmal bands.
  • A mini-facelift or lower facelift alone with incisions in front and behind the ears may be necessary to remove enough skin to flatten out these pseudo neck bands.  A thorough consultation with a board certified facial plastic or plastic surgeon should be done having you clench and unclench your teeth to carefully diagnose what exactly is going on.  If your examination is consistent with your description, then a lower facelift procedure to go along with your submentoplasty should complete the transformation of your neck profile.
  • In this age of the mini-facelifts and mini-necklifts (submentoplasty), sometimes doing too small of a procedure may result in too small of a result.  Most patients who have the combination of a lower facelift along with a proper necklift usually get the best results.  There is a synergy in combining the lower face and neck together, since the lower facelift can help the neck, and the necklift can help support the lower facelift result.  When performed alone, sometimes it's just not enough.

Best,

Dr. Yang


New York Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

It depends on the cause.

+3

 If they are truly small bands(muscle) they can be excised. I doubt that these are bands. It t is probably a pseudo-band caused by excess skin which would be best handled by a mini lift with fixation of the muscle behind the ear.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Botox

+2

I have done botox to this for my patients directly into the bands.  It has been very helpful.

The surgical option is to sew the neck muscles together, which is called a platysmaplasty.

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Persistent neck bands

+1

Persistent neck bands after surgery can be treated surgically by imbricating them or sometimes dividing them.  A non-surgical treatment is using botox. 

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Persistent neck bands after submentoplasty

+1

The bands in your picture can be addressed in several ways. If they are muscle bands, you can try some botox as a nonsurgical treatment that might help to diminish their appearance. Alternatively through a submental incision they can be either incised and removed or then can be sutured together. However, I caution you that sometimes suturing them in the midline can result in one hanging band especially if there is loose skin contributing to the cause. You might need some skin removal as well via a minilift or neck tightening procedure or possibly direct skin excision. You should see a qualified facial plastic surgeon in your area.

Scott Trimas, MD
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Corset platysmaplasty is different!

+1

Many doctors resuture the medial edges of the platysma together to eliminate these bands. The majority only tighten the bads to the anfgle of the neck, but no further. This gives some people the look you show. A corset platysmaplasty will tighten these bands all the way down your neck, giving a nicer and more durable results.

Lesser options include: Botox, needle transection fof the bands or filling the srea with fat to camouflage the bands.

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

There are 3 options.

+1

To tina0098,

Hi! Here are some suggestion:

1) Botox will erase these bands, but you have to do it three times a year.

2) With an isolated neck lift through a short incision under the chin, the muscles can be sutured together to create a sling and eliminate the bands.

3) The bands can actually be cut out through a half inch incision right over each band. The scars usually fade nicely and look like a natural fold low in the neck.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.