Neck lift with platysmaplasty, platysmaplasty alone, or mini face lift? (Photos)

Question

Not sure what is best for my neck. As I turned 46 I noticed some loose skin under my chin with the bands more evident now. I'm not sure what would be best to improve this. Google has me overwhelmed. I did go get a consult and was told that I am "not yet there" for a mini facelift and that it wouldn't improve my neck issue anyway. Not sure if liposuction alone will just leave more loose skin or that a facetite procedure alone will tighten the skin. Can a platysmaplasty alone help?

Richard G. Schwartz, MD · Answer

The real question is what has created the neck band(s).  It is probably a combination of loose skin mainly in the front of your neck and saggy platysma muscle border(s).  I don't see evidence of any significant extra fat on your neck or cheeks.  Your skin seems pretty smooth but with some looseness in the lower anterior cheeks resulting in a slight lower jowl bulge behind a depressed marionette fold.  I don't think Facetite or other technology would correct the neck banding.  I would suggest either a standard necklift with platysmaplasty in front, which would address the neck skin and muscles as well as the lower cheek at jawline, or a more limited platysmaplasty through a short submental incision, which would tack up the muscles but wouldn't tighten any skin.  An exam would be helpful to decide if your skin was elastic enough to snap back upward smoothly after that.

Jason Emer, MD · Answer

if you want more tightening you can do and early neck lift or facetite + platysma.   morpheus should be used every 2-3 months for tightening/collagen production.

most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift.  an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done.

For facial slimming a combination of treatments are always needed.  Options include:
1. Buccal fat pad removal to reduce fat on the lower face
2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping.
3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender
4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined

Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma.

See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Tanveer Janjua, MD · Answer

You will benefit from Neck platysmaplasty, Liposuction and Thermitight. However the best result will be from a necklift surgery. Necklift is similar to a lower facelift. 
Regards
Dr. J

Brian K. Machida, MD, FACS · Answer

Your problem requires muscle tightening which is not helped by Lipo alone or Facetite. You require a platysmaplasty with a lateral pull in the form of a necklift and/or facelift.

John L. Burns Jr., MD · Answer

I find it very difficult to just isolate the neck.  Combining the neck and lower face/jowls gives a more anatomically pleasing result with the lower face and neck in harmony.  Also, if you need a neck lift you almost always will benefit from a lower facelift.

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