43 years old - will a platysmaplasty alone solve my saggy neck skin as well as bands? (Photos)

Question

Follow up question. It looks like I will need surgery. My neck does not match the rest of me at all. I don't have jowling or facial wrinkles. My problem is isolated to this one area. Will a platysmaplasty with the scar beneath the chin solve the sagging skin as well as the banding? Botox isn't helping. Is this surgery a significant cost difference than a mini-necklift with ear/hairline scars? Ballpark? I am willing to travel to finally solve this ongoing problem. Thank you in advance for your expertise.

Philip K. Robb Jr., MD, FACS · Answer

Your pictures reveal a really great jaw line. Is that at rest? The neck muscle that's most prominent appears to be your SCM and not the platysma (the latter which is addressed in my neck lifts), The leading edge of the left platysma muscle is able to be seen and this can be treated with a neck lift. 
There are also some noninvasive therapies that can help with skin tightening but nothing will remove the neck bands that you're referring to. 
I hope this helps and God Bless!
Dr. Robb

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you consult with your board certified facial plastic surgeon.
Best wishes,

Jed H. Horowitz, MD, FACS · Answer

It's best to begin by consulting with a surgeon in-person to discuss your options. Depending on the level of laxity, the effects of a neck lift will certainly outlast the effects of non-surgical treatments. Non-surgical procedures can only temporary resolve the issue and require few to several attempts or treatment appointments. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck.
During your initial examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend alternatives to address your concern. Consulting with a board-certified plastic surgeon who specializes in #neck lift procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  Tightening of the platysma muscle (also known as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscles on the neck; they are sutured together with permanent stitches. The muscles of the neck are the foundations and building blocks of the neck and are fundamental to achieving a tight and toned result.  If there is skin laxity after the muscles have been tightened then neck lift involving incisions behind the ears will be needed, giving a nice contour of the neck.  Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Based on your pictures alone you appear to have underlying muscle laxity as well as skin excess.  For the longest lastly result, which would better match the views of your lower face I would advocate for a surgical neck lift that leaves scar under your chin and around your ears.  Hope this helps.

Gregory S. Keller, MD, FACS · Answer

We used to feel that a posterior to the ear incision needed to be performed with a platysmaplasty to obtain consistent results.  FaceTite has, to an extent changed my mind on this topic.  Published articles show that shrinkage of skin with FaceTite can is 25-35 %.   We have had a great experience with performing FaceTite first to shrink the skin and then perform a platysmaplasty in patients like you. We have performed approximately 30 of the FaceTite/Platysmaplasty procedures.  One patient did not receive an adequate result (for her), and had extreme skin laxity, The rest were extremely happy, and she did get significant improvement.  Without a consult or more pictures, I could not give an accurate assessment, but from what I see, this should give you an excellent prognosis for a great result.  FaceTite is definitely a proven technology, and has been in use for over 8 years. A side advantage is that there is very little bruising or bleeding with this procedure.

Bahman Guyuron, MD · Answer

Without a profile view it is hard to be sure whether you need some other structures adjusted as or not. However, your platysma bands can be successful and reliably eliminated using the Vest-Over-The-Pants technique that I have described and published an article about 25 years experience with this technique in the Plastic and Reconstructive Surgery journal. If you post or e-mail your profile images we can be of more helpful to you through this site, e-mail, FaceTime or Skype.Good Luck

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may
benefit from a mini neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Cost varies based on geographic region and surgeon expertise.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Prashant Soni, MD · Answer

a neck lift would be very effective. I do recommend utilizing the incision below the chin as well as the incision behind each ear. The chin incision will allow for tightening of the platysma muscles. The other incisions will allow for tightening and redraping of the neck skin. This should smoothen the entire neck. Some of the loose skin directly under the chin will tighten spontaneously as well in someone your age. I definitely believe that Botox to the neck every 6 months  after the neck lift is nescrssary to prevent new platysma bands from reforming. 
Best Regards, Prashant Soni M.D.

Ira D. Papel, MD · Answer

Platysma bands represent the loosening of the neck muscles which then form vertical lines from the chin to the neck. Loose skin can accentuate the bands. Both must be addressed to solve the problem which bothers you. The reality is that addressing the muscle alone will help,but it won't satisfy what you are looking for. Tightening the skin, with a facelift type incision, together with addressing the platysma muscle laxity will give you the best long-term benefit.

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