When having a second neck lift 10 years after the first, does the doctor typically tighten the platysma muscle again?

Jane,Thanks for your question.You will see a variety of answers, and most of us will remind you that the real answer depends heavily on an in-person exam but also depends on what is encountered at the time of surgery.We can make a few generalizations though.The incision that you had under the chin is typically used to sew the middle edges of the platysma muscle together.  That incision is also useful for loosening some of the skin in the central neck and removing fat if needed.  The side edge of the platysma is also tightened in most cases, so you may have had some work in the middle (traditional "platysmaplasty") as well as tightening at the lateral neck.The area where the platysma edges were sewn together is likely to still be together in the middle.  It is possible that some sutures may not have held up and the muscle edges could have drifted apart over time.However, what is more likely is that the platysma muscle and the skin of the neck have both regained some laxity over the last 10 years.  In this situation it can be helpful to consider revising a previous platysmaplasty.  In most cases some work in the neck is helpful in a situation like yours.  The real questions is not if anything needs to be done in the neck but rather how much (or how little) is needed to get the result that you want.What is also needed is tightening in the lower cheek and jowl area.  I often find that the deep place facelift technique (or extended-SMAS variation) can be particularly useful in the case of a revision facelift / necklift.  There is always some scar tissue under the surface from a previous surgery, and there is usually a good chance that the deeper technique that I prefer in this case can allow some additional work for an added lift and support when compared to simply trying to retighten what was already worked on.Feel free to get in touch if you have additional questions.  David RodwellCharleston, SC

Thank you for your question, Jane112. No, your surgeon should address the early sagging of the neck and jowls without tightening the platysma muscle but instead looking for a more long-term solution. I suggest you consult with your board certified facial plastic surgeon. The Laser-Assisted Weekend Necklift provides a natural appearance in a short and comfortable recovery time after a procedure that leverages minimal invasiveness under local anesthesia.Best wishes,

If your neck still looks adequate, you may not need another neck tightening.  Its bestto seek another consultation to determine what you need.

Plicating the platysma might not be necessary as in a number of secondary lifts as  a vertical drop of the cheek and cheekbone areas is usually  responsible of recurring jowls and blunting of the neck .Our Refresher lift is well suited to repair both issues  and often the sagging platysma can be corrected by a posterior approach without the need for a new plication and a neck incision . As always these recommendations need to be supported by a thorough evaluation prior to your surgery 

Whether or not you should have a 2nd platysmaplsty will depend on your physical examination at this time.  If the indications were there 10 years ago, they may or may not be present at this time.  Make sure you see an experienced Facial Plastic Surgeon.

Thank you for your question.If your first surgery was ten years ago, you likely have additional gravitational descent of your muscles.It would be more likely than not for a surgeon to re-do the muscle work for optimal results.Best wishes.

An in person facial exam has to be performed in order to give you the best options depending on your problem. If the muscle has given or has some laxity during that time, most probably you will need a touch up. Please consult with a board certified Facial Plastic Surgeon in your area.Hope this helps,Dr. Gus Diaz

Whether or not to open the neck depends on whether you need it.If you have recurrent bands and excess fatty tissue then probably the neck would need to be opened.

Jane112, that all depends on your exam so see an experienced facial plastic specialsist with good photos. Do your research! Good luck

A physical examination will determine whether your platysma bands have become prominent again. There is a reasonable chance that your surgeon will want to tighten them again (platysmaplasty). Your surgeon will discuss this with you during your consultation.