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.