What determines the need (or not) for a platysmaplasty?

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question. When opting for a neck lift, physicians may suggest cervicoplasty, platysmaplasty, or both depending on the patient’s individual needs. Cervicoplasty requires a small incision to tighten loose skin, while platysmaplasty is a surgical procedure that addresses tightness of the neck muscles, or platysmal bands. Considering the age-related band protrusion you’re describing, you may benefit from undergoing both procedures. However, I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your specific concerns to help you decide which procedures are right for you.

Thank you for sharing. A platysmaplasty may be necessary to achieve optimal results, especially if platysmal banding is a large part of the problem. In cases where the banding is present, but mild, the platysmaplasty can usually be avoided and the lateral neck tightening is usually sufficient to resolve this issue without having to perform additional open surgical procedures in the central neck. I avoid the platysmaplasty in most cases as my technique for neck lifting usually improves the central neck sufficiently without the platysmaplasty. Although, I do mention to patients there may be a slight chance of requiring subsequent platysmaplasty at a later date. Although, this is rare and can easily be performed under local anesthesia. In any case, the sensation of "choking" or neck tightness that persists beyond a few days postop is very rare. In fact, I've personally never had a patient complain or persistent sensation beyond the first week, when most of the swelling / edema resolves. I hope this answers your questions. Best of luck! Thanks again for sharing.
Kind regards,
Dr. Harmych

Only on the basis of in person evaluation, an experienced, board certified plastic surgeon with long experience in face/neck lift, can decide whether platysmoplasty is indicated or not. We open anterior neck in over 90% of face/neck lifts and perform platysmoplasty in most of them, but not all. Sometimes, decision to do platysmoplasty or not is made during surgery, when clinical situation dictates it. Hope this helps.

In each person's case, the surgical plan should be based on the anatomical causes of any aging changes found on examination. You should depend on the advice of a plastic surgeon experienced with necklift surgery. Keep in mind that what you see in the mirror may not accurately reflect the underlying anatomy. In my experience and that of many other surgeons, the addition of a platysmaplasty, with partial transection of the platysma borders, creates a smoother, more defined neck contour that lasts longer than just with skin tightening, in most cases. The lifting and suture support of the platysma has been found to be an important component of most necklifts. However, if the surgeon agrees that you don't have any muscle looseness, than perhaps just skin tightening and the lifting effect of the deep plane facelift will suffice.

A full set of facial and neck photographs are required to make a determination about how best to proceed. At 63 years of age, the two vertical bands in your neck are most likely due to the aging process of shortening and fibrosing the anterior most bands of the platysma muscle. In our practice, a lower face and neck lift involves tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fat deposits above and below the platysma muscle in the neck, lifting the jowls and performing a platysma plasty to significantly improve the jawline. When there are significant bands present, a myotomy is performed in the platysma muscle itself. Pre-surgical Botox placed in those bands also offers better improvement of the myotomy when their are significant bands present. The Botox prevents the bands from reoccurring after the myotomy