My platysmal bands are 5 cm apart. Can this be fixed during lower face lift?

What are the chances my platysma bands which are 5 cm apart can be successfully surgically tied when I have my lower face lift? One doctor says he will "try" as they are 5 cm apart. 2 doctors said not a problem doing so. Need a neutral's opinion!

Doctor Answers 15

My platysmal bands are 5 cm apart. Can this be fixed during lower face lift?

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Generally, a platysma separation can be corrected in most patients.

It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what can be done and how to do it without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your  plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Platysmaplasty Bands Tightening and Neck Lift

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Thank you for your question.  Platysma band needed to be corrected with a facelift and necklift procedure.  Without addressing the neck as well, the platysma bands will be tightened however you will be left with loose skin.  Tightening of the platysma muscle (also known as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscles on the neck; they are sutured together with permanent stitches. The muscles of the neck are the foundations and building blocks of the neck and are fundamental to achieving a tight and toned result. 

Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best 

Platysma bands can be helped

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Platysma bands can be helped during lower facelift.
This generally requires a separate incision under the chin to address and tighten the bands.

Lower facelift

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Generally speaking, correction of the platysma bands should be possible with most lower facelift and neck lift procedures. Of course, a careful physical exam is necessary to make this determination for your specific case. 

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 50 reviews

Fixing Platysmal Bands

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The best option is for an in person consultation to fully evaluate your specific anatomy.  5 cm is generally not a problem for surgery, but again, it depends on each patient's anatomy.  There are also different ways to address the platysma during surgery and all of these can be explained during your consultation.  Lower facelift is an excellent way to improve your neck and jawline while maintaining natural appearing results.  

Good Luck.  

Platysma plasty during a face lift procedure

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 A platysma plasty can accomplish sewing the platysmal bands together even  If they are 5 cm apart. A full set of pictures along with in-person examination is required to determine what can and cannot be accomplished. It's also important to know whether or not the platysma plan separation is present at rest, or upon animation.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Anterior neck bands

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It is impossible to correctly answer your question without detailed clinical exam. However, in most cases platisma bands may be brought and sutured together using submental (underneath the chin) incision. Additional posterior pull to tighten platisma muscle and create neck improvement and visible jaw line my be needed using incisions placed in front and behind the ear. This can be done as a part of full or lower face/neck lift depending of the extent of correction needed.

You should seek a consultation with an experienced board certified plastic surgeon for detailed clinical evaluation and discuss your options. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 22 reviews

Platysmal band correction in face-lift

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Hi there. Thank you for your question. Correction of platysma bands can often be achieved at the same time as lower face-lift. Suspension of the platysma muscle (through the facelift incision) may soften the bands. But, to eliminate them, a separate incision is required underneath the chin. Through this approach, the muscle ends can be sutured together in the midline removing the appearance of two separate bands. Good luck!

Platysmal bands are 5 cm apart. Can this be fixed during lower face lift?

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Hi, non smiling photos of your face and neck from the front and side would help in the evaluation. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. When significant anterior (front) neck bands are present, these can be plicated or sewn together as part of a formal Neck Lift. This type of neck lift will typically require some form of facelift to tighten the SMAS and remove excess skin from the face as the neck tissues are elevated and lifted upward and back at a 45 degree angle. In these cases, I combine the full neck lift with the minimally invasive SMAS facelift as described below.  That surgery takes about 5 hours and is best done under a general anesthetic.

Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews


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Thank you for your question.  detailed examination by a board certified plastic surgeon can usually provide you with an answer although it isn't always guaranteed. Tissue quality, mobility of the bands, the distance between them when you lie back which always increases, history of previous surgery in the area etc etc are just some of the factors to consider. When I  treat platysma bands I am usually confident as to whether or not I will be able to tie them. Alternatively if unsure I have secondary plan to address them from their lateral border instead which can be quite helpful. Occasionally the bands are too far apart to bring together in the midline and I review this with the patient. Previous surgery and widespread bands can make platysmaplasty very difficult if not impossible. It is important to examine each patient thoroughly so a plan can be formulated prior to surgery. Consultations with experienced board certified plastic surgeon should allow for a discussion of your options and cocerns so a plan can be developed to help you achieve your goals
Best of Luck

Lee A. Gibstein, MD
Miami Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.