Only 36 and so unhappy with my neck. What procedure would you recommend to smooth my neck line and eliminate neck bands? (Photo)

Neck bands present at rest. No extreme weight loss/gain, no previous procedures. Just unlucky and so self conscious. My goal would be to have a procedure that smooths my neck line and eliminates neck bands. Is this possible, a realistic expectation? What procedure is recommended? Cost in DC area? Complications/liklihood? Recovery time? Scaring? How long will results last? When/if the bands return, will they be worse than if I had nothing done? Please help!!! I'm miserable.

Doctor Answers 16

Neck lift

Based upon the pictures you have some platysmal laxity which shows as “neck bands”. A neck lift could be done to tighten the bands and improve the appearance. This would involve making an incision under the chin to get access to the muscle/bands. From this incision the bands could be sutured together to eliminate the appearance and give you a more refined appearance. As with all procedures complications include: Anesthesia, bleeding, infection as well as possible scarring. You appear to be a good candidate based on the photos. However, before recommending any definite treatment plan you should have a consultation with a surgeon. Recovery depends upon what technique is used, this will ultimately be determined at a consultation. The results should last for years if you maintain a healthy diet, exercise and do not have significant fluctuations in your weight. Typically if the bands return they can be touched up. Normally this should be several years.

Tampa Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Neck Bands

The bands on you neck are visible because your underlying platysma muscle is split and it has stretched the skin. This will require a procedure to provide long term correction. Either a platysmaplasty or mini-neck lift would work. I would recommend the mini-neck lift if the skin is quite loose, but this could only really be determined after an examination by your surgeon. Both procedures can be done in the office and it does not require general anesthesia. The cost would be $5K to $9.5K depending on the procedure needed. The results, especially in a young person, should last 12 to 15 years. If the bands return, the procedure can be repeated. Scaring is minimal. The platysmaplasty requires a small incision under the chin and the mini-neck lift requires an incision around the bottom and behind the ear. Both scars are inconspicuous. There can be complications with either procedure, but are unusual.

Franklin D. Richards, MD
Bethesda Plastic Surgeon
4.8 out of 5 stars 133 reviews

36yo neck bands

Hello Me x 3-
You are young and look youthful. Please try botox in these neck bands but make sure the enough of the medial edge of the platysmal band is injected. This is your best option currently.
A conservative anterior neck dissection with approximation of the medial bands and back-cutting of the platysmal muscle may be option, but understand the risks. 
Good luck.

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 37 reviews

Neck bands neck lift

A temporary solution would be Botox.  This may last 3-5 months.  Since it appears that you have little fat, I don't think liposuction of neck will improve your situation and could make it worse.  So a mini neck lift would improve the appearance.  

Sharon Y. Giese, MD
New York Plastic Surgeon
5.0 out of 5 stars 10 reviews

Neck bands

I think your best option is an anterior platysmaplasty. The cause of your anterior neck bands is the hanging of your anterior border of the platysma muscles. The procedure may be performed under local anesthesia with mild sedation. An incision is made a few millimeters behind the chin crease if you have one and is about an inch long. The skin is dissected away from the anterior muscle borders and then the muscle border is cut for about an inch and then the anterior borders are sutured together. The surgery should take less than one hour. A snug dressing or chin strap is placed after the surgery and worn for a week at which time the sutures are removed. A chin strap is to be worn intermittently for a month. There are few complications with this procedure. A temporary alternative is to try Botox injections along the anterior border.

Howard N. Robinson, MD (retired)
Miami Plastic Surgeon
4.7 out of 5 stars 62 reviews

Treatment of Neck Bands in the young

You have both static and dynamic neck bands with some loose skin. There are essentially 3 things that can be done. First, you can treat the bands with Botox. This will require a significant amount of product and someone very skilled to prevent problems with other structures in the neck and to get the result you wish. you are young enough that, hopefully, the skin will redrape. If this does not work, then surgery is indicated. There are two options, neck lift or facelift. For me, I do not do standard neck lifts. Instead, I would dissect the muscle anteriorly, divide the band at the hyoid level and plicate the muscle superiorly. I also do not like a standard SMAS lift for someone your age. I do a modification of a MACS Lift for everyone, but it is absolutely the only thing I would use in someone your age. This will suspend the muscle, but you will still need anterior muscle plication and band division. See a plastic surgeon with significant experience in both use of Botox and face and neck lifts.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Only 36 and so unhappy with my neck. What procedure would you recommend to smooth my neck line and eliminate neck bands?

Appears a few issues related to aging. The Platysmal bands, slight if any neck skin laxity. The simple first treatment for temporary improvement of the banding is the use of BOTOX (most likely 80 to 100 units fee $1200). Otherwise even 'cutting' the bands is a very difficult option that costs thousands with poor results. As for neck laxity either non invasive RF therapy, minimal invasive ThemiTight RF, or a neck lift. Best to seek a few IN PERSON opinions!!!  

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Neck rejuvenation candidate

 The photographs appear to demonstrate  static and dynamic platysma muscle cords. There is also extra skin located in the neck. An in person consultation and examination would be required to determine whether or not a neck lift versus a face/neck lift would be required to rejuvenate the neck. A neck lift would involve a platysma plasty to simply tighten the neck cords. A face and neck lift will address any laxity of the skin. For many examples of both procedures, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Neck bands

Dear Me x 3,
Thanks for submitting your pictures. From the pictures it appears that you have very little skin laxity and mainly sub mental and lateral platysma muscles bands.  Since you are so young, you have few options : 1. Botox injections - They need to be repeated every 3 -4 months and will eliminate or significantly reduce the bands. There is no surgery and no down time. 2. Platysmorrhaphy - Small incision under the chin. Undernining the skin and exposing the platysma muscles that are being undermined too, subsequently. If there is fat under the muscles centrally , it is  removed and the muscles are being plicated and the excess muscle is excised. 3. Neck lift - This option appears to be excessive in your case because it's done to tighten excess skin and muscles laterally and the incision goes around the lower ear , extending into the hairline. 4.  MACS  face lift - This option is good if you have deep naso labial folds, tear trough deformity and jowls. This surgery is the most comprehensive and improves on the face and neck, including the bands. The incision goes from the pre temple hairline ( the incision here is beveled and allows hair to grow through it and camouflage it ), continuing downward and ending around the ear lobes. In summary, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, make sure that the surgeons show you many before and after pictures  that are consistent and attractive. Discuss cost issues with the surgeons, because as you can see, there are few treatment options and there is the additional time element that is dependent on the complexity of the procedure. The cost of Botox in my practice is $12 per unit.
             Best of luck,
                            Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 126 reviews

Vertical Deep plane neck lift

First off, you seem to have a very nice lower face and neck line at rest.  I wish I could age as well as you.  I do see the banding your'e talking about though.  the simplest non-invasive way to improve them a bit is to botox them, but this is just for a subtle improvement.  For a more significant improvement you can proceed to have a procedure and there are two different procedures that would give you the most benefit and last likely 10years.  the most significant is called a deep plane vertical neck lift which means that platysma muscle is elevated under and over from a limited facelift incision and the muscle is tightened then the excess skin is removed.  this would give you incredible results and you could do facial rejuvenation at the same time.  A more direct approach is called a midline neck lift or a midline plastymaplasty.  There are dozens of way to do this, the most common of which is called a Corsette platysmaplasty which was originally described by Dr. Feldman.  Either way you have great anatomy and you will do great as long as you pick a surgeon who does this stuff all the time.  The cost in DC is a little less than NYC and Beverly hills and ranges depending on which procedure you choose and if you use general or local anesthesia.  Typically the midline work cost less and can range from 4-12k  while the vertical lift which could also address the face simultaneously would range from 6-13k depending on the surgeon and facility. Complications are very rare but include the typical hematoma, recurrence of banding, infection, scarring etc.  Recovery time is about 10days for the majority of swelling.  Scarring is rare is you use the right techniques.  It should last 10 years typically if you use a good technique. If they bands return they would typically not be as bad at that time unless you get a poor quality surgery honestly.  Best of luck

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 48 reviews

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