Prominent Platysmal Bands at a young age (24 yo). What to do?

Question

I've had these bands since I was a teenager, happens only when I smile. I'm wondering what procedure is best to reduce their appearance long-term (i.e., not Botox). Would a closed platysmaplasty be of any benefit? What type of platysmaplasty would you consider is best for this issue at a young age, considering the many different procedures (closed, corset, behind the ear, etc.). Which would give the best results, last long-term, and has less chance of reoccurrence?

Brian K. Machida, MD, FACS · Answer

It looks like in one photo the band is not visible. However the band is more visible with a grimace. In addition, this band is fairly strong and is thick. You could try botox first. A platysmaplasty is another option however due to the thickness and likely strength of the band, dynamic action could overpower the surgery result because surgery is designed to correct static deformities and not dynamic deformities. In addition, this band goes fairly far inferiorly in the neck. It is fairly difficult to reach inferior with a platysmaplasty. In general, try botox first and it might take a fair amount and then see various consults to see what they can offer.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Botox is best used for dynamic lines or neck bands that are dynamic (or those appearing with muscle contraction).  Botox can treat dynamic platysmal bands very well, but does not address well static (appearing at rest) bands or skin laxity.  Depending on your exam findings, you may need Botox, Ultherapy or some other non-surgical skin tightening procedure, or surgical intervention.  Start by consulting with a plastic surgeon or facial plastic surgeon who offers a wide spectrum of surgical and non-surgical options to discuss your concerns and develop a treatment plan.

Alejandro J. Quiroz, MD · Answer

Thank you for your question.  Yes, you are young to have this prominent platysma bands.  The only reliable treatment for platysma bands is Botox but is not a permanent solution or surgery.

Thomas Trevisani, MD · Answer

Based on photos- it a appears that neck lift with muscle tightening will be of benefit. The platysma muscle must be addressed deep in the midline by transaction, excision, and plication laterally.  In the right hands you can expect a very pleasing outcome. I suggest that you seek an experienced Board Certified PS

Nelson Castillo, MD · Answer

Thank you for sharing your question.  At your age Botox would be most advantageous, but if you want to try and correct it for the longer term surgery, and its associated scarring, would be path.  This would include cutting the platysmal muscle and tightening it to try and reduce the band's prominence.

Prominent Platysmal Bands at a young age (24 yo). What to do?

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Answer: Prominent Platysmal Bands at a young age (24 yo). What to do?

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do?

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do? (Photos)

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do? (Photos)

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Prominent Platysmal Bands at a young age (24 yo). What to do?

Answers (7)

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do?

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do?

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do? (Photos)

Answer: Prominent Platysmal Bands at a young age (24 yo). What to do? (Photos)

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Everything you need to know about Neck Lift

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