Neck muscle falling after deep plane facelift - what corrective options do I have? (photo)

Question

I had a deep plan facelift approximately 10 months ago. Within the last month, there is a strip of muscle that has dropped, running from the center of the chin and down the neck. What could have caused this and what corrective options do I have? Thank you

Carey Nease, MD · Answer

This is fairly common and is the inner edge of your platysma muscles. In some cases they are sutured together but they pull apart over time in some cases, especially if they are strong. This can be treated with Botox or a simple revision of the surgery to suture them back together, which is not a big deal and can be done with local anesthesia. Consult your surgeon for his/her opinion first and then another one if you don't get the answers you expect or hope for. Thanks!

Brian M. Harmych, MD, FACS · Answer

The most likely reason for this problem is scarring due to neck liposuction or midline neck surgery, such as platysmaplasty. With more modern deep pane facelift techniques, generally the central neck does not need addressed (with liposuction or otherwise). This is likely scar tissue forming along the edge of the platysma muscle secondary to liposuction. Often, these scar bands can be softened with steroid injection. Although, this should be done sooner than later so the scarring doesn't harden and become "permanent". Thank you for sharing the question and photo.

Gianfranco Frojo, MD · Answer

This could be a persistent platysmal band or a scarred hypertrophic area from excessive correction of the muscle in the midline. Regardless, the ideal plan could only be made after evaluation with a full physical exam. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Dilip D. Madnani, MD, FACS · Answer

Did you also get a necklift at that time? A necklift involves a separate incision under the chin, and it ties the platysmal bands together, those are the bands that you are seeing in your neck.

if you did have one performed, then consider some botox in the platysma muscle, as in some patinets, its very strong and needs some relaxing after surgery.

otherwise, sometimes patients need touchups after surgery to improve on whats already been done, so pls have that conversation with your surgeon.

Jigar Sitapara, MD · Answer

Good morning from Washington DC,Thank you for your question and the photo. It appears as if we are seeing something called a platysmal band. The platysma is a sheet of muscle in the neck and lower face that is released during surgery and resuspended back and up. Sometimes during a deep plane facelift, surgeons may perform platysmaplasty from an incision under your chin to put that muscle back together in the midline. If they performed that procedure, some of the sutures to put that muscle back together could have split or your muscles were just too strong for the surgical correction. Even with surgery, it is very difficult to get those platysmal bands to go away forever. Thankfully, some botox/neuromodulator can be used to relax the muscle and decrease it's visibility. Should be a quick and easy fix. Best of luck and I hope this helps!Jigar Sitapara, MDChevy Chase Facial Plastic Surgery

Marc Polacco, MD · Answer

Thank you for your question. The muscle you're noticing is called the platysma. Usually in a facelift, this muscle is tightened. At this stage, likely the best solution would be to inject the muscle with botox, which would make it less prominent. The muscle band can also be addressed surgically if needed under local anesthesia. I hope this helps, and I wish you all the best.
-Dr. P

Ronald J. Edelson, MD · Answer

You have had a recurrence of the platysma band which sometimes occurs. Simple to fix through a small incision under the chin. You probably have a scars there from the first surgery anyway

Akshay Sanan, MD, FACS · Answer

Thanks for uploading your photo. The muscle you see is your platysma muscle. The bands can recur after a deep plane facelift. Your options are to inject the muscle with Botox, or to make an incision under the chin and tighten the muscle with stitches. I hope this helps answer your question.
All the best,Dr. Sanan, MDFacial Plastic SurgeryLos Angeles, CA

Neck muscle falling after deep plane facelift - what corrective options do I have? (photo)

Answers (8)

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