Do sutures hold the platysma in place until muscles are fully healed?

Question

When the plastysma is sutured together, is the aim for the sutures to hold the platysma in place until the muscles heal together in their new position? Or do the muscles not heal together and are held together tighter only by way of the sutures? Is there any risk of the platysma sutures coming undone?

Adrian E. House, MD, FACS · Answer

Platysma sutures are typically used to reposition the underlying muscles during procedures like a neck lift. The sutures help to approximate the muscles in their new position and provide support during the initial healing phase. While sutures play a role in holding the muscles in place, the healing process involves the body's natural mechanisms as well.
Over time, the body's healing response, which includes scar tissue formation, helps to stabilize the repositioned muscles in their new location. The sutures act as a temporary aid during this process. In my opinion, even when they are "permanent" sutures. I have seen failures of a platysmaplasty in patients who come to me for revision surgery and when I open their neck, I find permanent sutures. So yes, there can be risk that the sutures come undone, which is why I do a double-layer closure for all of my platysmaplasty cases (using dissolvable suture that takes between 3-9 months to breakdown).
It's important to have a detailed discussion with your surgeon before the procedure to understand the approach they'll be using, the expected outcomes, and any potential risks involved. This will help you make an informed decision and set appropriate expectations for your recovery.

Randal Haworth, MD, FACS · Answer

During a platysmaplasty procedure, the aim is to tighten and reposition the platysma muscles in the neck to create a smoother and more youthful appearance. The surgeon typically sutures the platysma muscles together to hold them in their new position and provide support during the healing process.

The sutures are intended to keep the muscles in place while they heal and scar tissue forms, effectively maintaining the desired contour and tightening of the neck. Over time, the body's natural healing processes help the muscles to adhere in their new position, making the sutures less critical as the scar tissue stabilizes the muscles.

While complications and risks are possible with any surgical procedure, the risk of the platysma sutures coming undone is generally low. Surgeons use techniques and materials designed to minimize the chances of suture failure. It's essential to follow post-operative care instructions carefully and have regular follow-up appointments with your surgeon to ensure proper healing and address any concerns that may arise during the recovery process.

I hope this helps,
best of luck !

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your thoughtful question. There is still not a clear cut consensus among surgeons. That is why some use dissolvable sutures and others use permanent sutures. There is certainly a risk of sutures coming undone but more often the sutures pull through the muscle and this can result in recurrent neck bands. Of note, necklift can be done wide awake using local anesthesia and oral medications to help you relax. Patients do incredibly well with this and it avoids the side effects of general anesthesia.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Zoran Potparic, MD · Answer

Purpose of platysmaplasty sutures is to hold platysma muscle in desired position until muscles heal with scar; this happens within 6-12 weeks after suture placement. In this particular case, there is minimal tension on sutures and likeliness of sutures coming undone is minimal. Hope this helps.

Henry Wilson, MD, FACS · Answer

I assume you are referring to platysmaplasty--procedure performed to bring the left and right parts of a platysma are brought together. This can be done with either permanent or absorbable suture; after 2-3 months and probably sooner, the muscles have scarred together enough that the suture is no longer really needed. This is why many surgeons use absorbable suture for this repair. Hope that helps!

William Portuese, MD · Answer

Yes,  platysma plasty sutures hold the platysma muscle in place once the neck shin has been tightened, and fat deposits are removed from both above and below the platysma muscle itself.

Do sutures hold the platysma in place until muscles are fully healed?

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