Retroplatismal resection of platysma muscle and thyroid suspension

Question

Hi, I had a facelift and neck lift, over a year ago. I have no complaints,however, l have a double chin. I didn’t before. And it’s wide not just under the chin but under the jawline. It isn’t dramatic but definitely noticeable enough as people ask. My surgeon suggested Retroplatismal resection of platysma muscle and thyroid suspension " Is this standard after so much surgery

Jeffrey M. Darrow, MD · Answer

I don’t have the benefit of a physical examination, however, I have never heard of a retro platysmal resection of the platysmal muscle, nor a thyroid suspension being done to rejuvenate a patient’s neck.  Some patients do require removal of redundant platysmal muscle, but this is usually a simple trimming of the muscle from an incision which is placed just underneath the chin. If thyroid suspension has no place in facelift surgery. As safety is a priority, I would recommend that you seek additional opinions. Best wishes.

Lucian Ion, FRCS · Answer

Hello,

Thank you for your question and for providing details about your situation. Based on your description and the recommendations from your surgeon, I understand your concerns about the appearance of a double chin after your facelift and neck lift.

Understanding the Recommendation:

The recommendation for retroplatysmal resection of the platysma muscle and thyroid suspension may actually be referring to a deep plane neck lift intervention. This involves the reduction of deep-seated fatty tissue, which is situated centrally under the chin. Lateral to this fatty tissue are the digastric muscles, which can also be reduced. Further lateral to these muscles is the lower part of the submandibular gland. All of these structures are situated under the platysma muscle and can be addressed by a deep plane neck lift intervention.

Common Causes:

The fullness and impression of a double chin you are experiencing tend to be associated with volume situated deep to the platysma muscle. This can become more noticeable after the jawline contours have been lifted and the jowls area has been corrected.

Is This Standard?

In cases where a double chin appears or persists after a facelift and neck lift, it is not uncommon to address the deeper structures under the platysma muscle to achieve a more refined result. This procedure can help remove the remaining volume that contributes to the double chin appearance.

Next Steps:

I recommend discussing the specifics of the proposed procedure with your surgeon to ensure you fully understand the steps involved and the expected outcomes. It might also be helpful to ask for before-and-after photos of similar cases they have treated to get a better idea of the potential results.

Conclusion:

In summary, the recommendation for a deep plane neck lift with reduction of deep-seated fatty tissue, digastric muscles, and the lower part of the submandibular gland can effectively address the issues you are describing. It is a reasonable next step to consider for refining the contours of your neck and jawline.

Arnold Almonte, DO · Answer

It’s difficult to advise you without any photographs. But needing additional surgery isn’t out of the ordinary if your initial procedure didn’t achieve your desired goal. Everyone’s anatomy is different, as is everyone’s healing process. I suggest obtaining a couple of opinions from facelift experts as to what procedures should be pursued next. But it’s also helpful to be open to having realistic expectations. All the best!

Retroplatismal resection of platysma muscle and thyroid suspension

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