The best way to avoid the "noose-like" sensation following a platysmaplasty?

Question

Hi! How to avoid that "chin strap" feeling after SMAS lift with Submental Platysmaplasty? Is it better to minimally tighten laterally and then concentrate on the submental portion of the neck? I am really afraid of having that feeling.....it scares me more than anything else in regards to a SMAS and neck lift. Please advise!!!!

George Bitar, MD · Answer

Unfortunately there is no way to completely avoid a tight feeling after a necklift.  It is a necessary step in correcting neck contour.  It usually improves with as the swelling resolves.  It will not compromise your breathing or swallowing.  You may need some assistance in managing your anxiety during your recovery. Best wishes.

Kenneth Hughes, MD · Answer

If you do not have visible banding of the platysma, then a SMAS 
facelift is reasonable.  If a great deal of banding is present then the 
platysmaplasty should be performed at the same time.    Performing both is done routinely and I have not had that complaint.Kenneth Hughes, MDLos Angeles, CA

Jeffrey Epstein, MD, FACS · Answer

Well,
I advise patients that this tight sensation is a reflection of the tightening
of the upper neckline muscles.  It can be avoided, but of course means
less of an elevation/tightening of the platysma. which means a less impressive
improvement.  You need to discuss this with your surgeon.

Grady B. Core, MD · Answer

This sensation is nothing to be afraid of. What you are most likely concerned about is the sensation of it being tight and restricting breathing. It does not in any way constrict breathing and it is nothing to be worried about. Without it you most likely will be disappointed in your neck although I see no photos not I can be for sure. Approximately 20% of my patients do not need it. However, even in the ones that do, I have never had a patient uncomfortable in any significant manner. I feel you have taken some peoples anecdotal comments and blown them out of proportion to reality. You will be fine and sensation of tightness is not bothersome to such an extent.

Brooke R. Seckel, MD, FACS (retired) · Answer

Tightness of the neck is desirable in the first week or so after neck lift because the tissues always relax and if you do not feel tight in the beginning your result will be compromised and the neck will re-sag and the platysma bands reappear.However it is a general feeling of tightness and does not feel like a Noose.There is however a suture method that uses a permanent suspension suture placed from the ear to ear across the neck, often called the Giampappa suture or neck suspension suture which can create thisNoose like feeling.  Ask your surgeon not to use this suture.

Randy J. Buckspan, MD (retired) · Answer

The tight feeling is a good sign that you have had a good procedure!  The tightness is actually over your upper neck above your Adam's Apple so you will not have any trouble breathing or choking.  Some of that feeling is really just temporary numbness that makes it "feel" tight.  It definitely WILL relax with time.  Let your doctor explain the procedure and what to expect, then let him do what he is trained to do.

The best way to avoid the "noose-like" sensation following a platysmaplasty?

Answers (6)

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