Neck Lift Complication - Submental Scar Tissue Causing Platysmal Rupture. Is This Common?

If no incision was made underneath the chin, your problem is a curious one indeed.

Many patients have a separation of the platysma.  A lift that pulled the platysma apart could worsen that problem.  Fortunately it would likely be improved with a platysmal plication procedure.  There are different plication methods, so there is hope.

If your platysma was cut horizontally, this approach predisposes to showing of the glands below the jawline and hematoma formation.  It can also decrease neck bulk over time.  It can be repaired but requires both a platysmal and facelift incision to repair.

It sounds as though you have had a tough recovery, sorry to hear that.

Fortunately, most complications following neck lift surgery are rare and self-limiting. The most common adverse event following a neck lift, which is not even considered a true complication, is slight asymmetry or under correction. These issues can often be addressed during an additional procedure performed under local anesthesia in an office setting.

More serious complications include blood or fluid collection under the skin that must be drained in the operating room. Rarely, a branch of the facial nerve may be injured during a neck lift, resulting in a temporary weakness of one side of the lower face. If this occurs, facial nerve function usually returns without further intervention in three to six months.

Platysmal muscle banding, inadequate undermining, excessive trauma, persistent fat pads, blood or fluid collections, and other unforseen issues can complicate neck lifts with irregularities and subsurface scarring.  There is great potential to minimize these irregularities by judicious compression and ice packs early after surgery, also massage and thermal wraps in the later post operative period.  I have been impressed with the use of cold lasers for tissue recovery acceleration and pain control.  Unfortunately, some of these irregularities will require revisional surgery that can be safely done after 3 to 6 months after the inflammation of surgical trauma has subsided.  Work closely with your surgeon on your postoperative course to optimize your results.

It certainly is possible to have multiple different problems after face or neck lift surgery. Although small hematomas, infection and salivary gland infection are rare, you are the evidence that they can happen in one patient.

I certainly would not jump to the conclusion that this is your surgeon's fault - both of you had rather bad luck.

In terms of rupture of the platysma, I am not quite sure what you are describing. The platysma is a very pliably broad sheet of muscle. If you do not have an incision under the chin, then lifting is usually accomplished from the sides making breakage of the muscle under chin highly unlikely. I would suggest to have your facelift surgeon explain to you how he got to his diagnosis.

A platysma rupture is not a true diagnosis and I can't even imagine what that means. In some instances, plastic surgeons practice complete transection of the platysma muscle. Hematomas tend to occur in patients with hypertension or on antocoagulants.