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

I want to have a second neck/lower face lift. My first was about 10 years ago and the doctor made an incision under my chin to sew the platysma muscle together. Is this step usual done again with a second neck lift?

Doctor Answers 11

Neck revision

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

Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews


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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,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Tighten platysma again in second facelift

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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 Rodwell
Charleston, SC

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon

Having a second neck lift 10 years after the first

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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

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon

Depends upon your result

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

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

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

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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.

Warren J. Katz, MD
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 19 reviews

Revisional face and neck lift

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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 

Platysmaplasty with 2nd Facelift?

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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.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Secondary neck/face

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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.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Second neck lift 10 years after the first, does the doctor typically tighten the platysma muscle again?

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  Hi, I have performed many facelifts over the past 30 years.   Non smiling photos of your face from the front and side would help in the evaluation.  While the SMAS muscle layer should always be dissected, lifted, trimmed and tightened the Platysmal layer may or may not need plication this time around as is required in a Formal Neck Lift.  A minimally invasive technique might be done as described below.  

  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation using a dermal filler (I prefer Restylane Lyft) or with cheek implants for a permanent enhancement will create full, round cheeks anteriorly that will feminize the entire face.

 Jowls are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured.  The excess skin is then removed and the facelift incisions closed.  Excess neck skin can be removed through an elliptical incision under the chin.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane and subperiosteal facelifts) but with these added benefits:

•very small incisions
•minimal tissue dissection = less bruising and swelling = rapid recovery
•can be performed in 90 minutes or less, with or without anesthesia
•no incisions within the hair = no hair loss
•excess fat can be removed
•excess skin removed
•cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
•most patients fly back home to parts all over the world in as little as 3 days post-op
  I tell potential facelift patients to think of creating a more beautiful or handsome face by working on three tissue levels.  The bony structure should be appropriate to make a woman’s face heart shaped and a man’s face chiseled and angular which is described below.  Next the fatty layer should be reduced or shaped allowing the shape to be seen and finally excess SMAS and skin evidenced by the presence of jowls) should be removed from the face and neck.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.