Adrian E. House, MD, FACS

Platysma sutures are typically used to reposition the underlying muscles during procedures like a neck lift. The sutures help to approximate the muscles in their new position and provide support during the initial healing phase. While sutures play a role in holding the muscles in place, the healing process involves the body's natural mechanisms as well.

Over time, the body's healing response, which includes scar tissue formation, helps to stabilize the repositioned muscles in their new location. The sutures act as a temporary aid during this process. In my opinion, even when they are "permanent" sutures. I have seen failures of a platysmaplasty in patients who come to me for revision surgery and when I open their neck, I find permanent sutures. So yes, there can be risk that the sutures come undone, which is why I do a double-layer closure for all of my platysmaplasty cases (using dissolvable suture that takes between 3-9 months to breakdown).

It's important to have a detailed discussion with your surgeon before the procedure to understand the approach they'll be using, the expected outcomes, and any potential risks involved. This will help you make an informed decision and set appropriate expectations for your recovery.

I'm sorry to hear about your experience. A neck lift, in combination with a facelift, may indeed be able to address the concerns you've mentioned. During this surgery, the skin and muscle is raised and sculpted on a deeper level, and any excess skin laxity is removed.

It's important to communicate your specific concerns and goals to whoever your surgeon is, so they can tailor a treatment plan that aligns with your expectations. They can also provide insights into how a neck lift can improve the appearance of the neck area and discuss the possibility of achieving the results you're seeking.

Given your unique circumstances, a thorough consultation will provide you with a better understanding of the potential outcomes and help you make an informed decision about your next steps. I would recommend considering a deep plane facelift with possibly CO2 laser at the same time or after you fully recover.

I'm sorry to hear about your experience. Given your concerns and upcoming wedding, it's important to explore options for improving the appearance of your neck. Considering your history of a previous neck and facelift with platysmaplasty, I would recommend going in person to a facial plastic surgeon for an examination. It really depends if the source is excess submental fat, muscle laxity, or other factors. Treatment could involve addressing submental fat with liposuction, revising the platysmaplasty, or considering other techniques to improve the neck contour.

It's important to communicate your specific goals, concerns, and timeline, especially with your upcoming wedding, with your surgeon. The surgeon can then tailor a treatment plan that addresses your unique situation and helps you achieve the best possible result, taking into account the timeframe before your wedding. I tell all my patients to plan surgery at least 4 months before any major event like this. Remember that each individual's situation is unique, and a personalized consultation will provide you with a clear understanding of your options and potential outcomes.

Considering your active lifestyle and desire for a non-invasive solution to tighten the skin around your neck, there are options available that could help improve your concerns.

One effective non-invasive treatment is radiofrequency (RF) technology, which stimulates collagen production and tightens the skin. Procedures like Thermage, Profound, Morpheus 8, or Ultherapy use energy to target the deeper layers of the skin, promoting collagen remodeling and tightening. These treatments can be beneficial for individuals looking to address mild to moderate skin laxity without surgery.

Another option is microneedling or CO2/HALO lasers. This will help with skin-level laxity or decrease in elasticity, as well as resurface the top layer of skin. You may also consider a neck lift if you have platysmal bands.

It's important to have a consultation with a qualified medical professional who can assess your unique concerns and determine the most suitable treatment plan for your specific needs. They can provide personalized recommendations based on your anatomy, skin laxity, and desired results. Remember that results from non-invasive treatments may vary, and multiple sessions might be needed to achieve optimal outcomes.

Considering your history of surgery 8 years ago, a revision facelift combined with fat transfer could be an effective solution. It's important to note that the longevity of facelift results can vary depending on the surgical technique used and individual factors. Generally, a facelift can last between 5-10 years or even up to 15 years, but eventually, further signs of aging may become noticeable.

Since you mentioned that the previous fat transfer under your eyes didn't take well, there are other options to consider for restoring volume and addressing the hollow areas. Fat grafting can be attempted again, as it's possible that the "success" of the procedure may vary. Additionally, alternatives such as Renuva, which is an injectable treatment for restoring volume using processed adipose tissue, could be explored.

Another option is to consider dermal fillers to restore volume and improve the appearance of hollow areas. Fillers can provide a non-surgical way to enhance facial volume and improve contours. Additionally, a revision lower blepharoplasty with fat repositioning may help address the concerns under your eyes, providing both volume and rejuvenation.

I recommend scheduling a consultation with a facial plastic surgeon who has experience with revision procedures. And particularly deep plane facelifting. They can assess your unique facial anatomy, discuss your goals, and recommend the most appropriate treatment plan tailored to your needs and desired outcomes.