Platysmaplasty fail 12 years ago - what is the most minimally invasive approach? (Photo)

Question

I had a platysmaplasty approx 12 years ago at the age of 47. I was never happy with it and went back to have excess skin removed and the scar revised. It never has looked right and now the banding is back. I also have some lower face sagging. What is the most minmially invasive aproach I could consider?

Stephen Prendiville, MD · Answer

Thank you for your question. The only way to satisfactorily address this kind of issue is a deep plane facelift with deep necklift.  There is no minimally invasive treatment that will provide benefit.

Ali Riza Öreroglu, MD · Answer

Considering your previous platysmaplasty, the return of banding, and some lower face sagging, I would personally recommend a deep plane facelift combined with a neck lift. Is seems like challenging to be solved minimally approach.
With a deep plane facelift, I reposition the underlying tissues of the mid and lower face rather than just tightening the skin. This helps correct sagging and lines while maintaining a natural, youthful contour.
During a neck lift, I specifically target the platysma bands and excess neck skin, smoothing out the banding and creating a firmer, more defined neck appearance.
A single photo may not show the full picture, so I always recommend an in-person evaluation. This allows me to determine the safest and most effective approach tailored to your face.

Mark Beaty, MD · Answer

Given your history and the recurrence of platysmal banding along with lower face laxity, the option most likely to provide a meaningful and lasting improvement would be a revision face and neck lift using a deep plane approach, performed by a facial plastic surgeon who routinely handles revision cases.

While it’s completely understandable to prefer the most minimally invasive option—especially after a prior unsatisfactory experience—procedures such as injectables, energy-based treatments, or limited skin tightening tend to offer only modest or temporary improvement in situations like this and may not adequately address muscle banding or deeper structural issues.

In many cases, the most natural and predictable results actually come from more comprehensive surgical correction rather than repeated minor procedures.

I would strongly encourage obtaining multiple consultations with double board-certified facial plastic surgeons who specialize in revision face and neck surgery, and to carefully review extensive before-and-after photos. This will help you determine the approach that best aligns with your goals and comfort level. Obtaining the op note prior to your consultations can be beneficial for the surgeons to understand exactly what was done during your prior procedures.

George Marosan, MD · Answer

Thank you for your question and photo. The most minimally invasive procedure to fix your neck is a full facelift and neck lift. Anything less than that will result in further disappointment and failure. This is not a minor problem and there are no quick fixes, or cutting corners. Suggesting less of a surgical (there are no non-surgical treatments) although it might sound tempting, will lead to further disappointment. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Zoran Potparic, MD · Answer

It is very likely, based on this photo, that a combination of lower face and neck lift would give you the best result in experienced hands. In person consultation with a reputable, board certified plastic surgeon is recommended. Good luck.

Sean Fisher, MD · Answer

based on the limited photos provided, a revision lower face/neck lift is likely needed to address the combination of recurrent banding and skin laxity of the neck. Minimally invasive options are likely to still be costly and are unlikely to improve things to a degree that you are happy with. I would recommend meeting with a plastic surgeon with advanced experience in facial rejuvenation who can discuss surgical options with you and come up with a plan that fits your goals and expectations.
Sean Fisher, MD Aesthetic Plastic SurgeonSeattle, WA

Darryl J. Blinski, MD · Answer

Based on the one post a photo only a full neck lift with muscle plication would effectively improve these appearances as seen in the one post a photo expect feed arrange from 10,000 of $20,000. Best of virtual consult with.

Platysmaplasty fail 12 years ago - what is the most minimally invasive approach? (Photo)

Answers (7)

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