Platysma muscle pulled forward or submandibular gland? (Photo)

Question

Doc did platysmaplasty with single chin incision, no ear incisions or lateral fixation. No fat or skin removed, solely to correct platysma bands. After 3 months I have bulges on either side of jaw, but the right side is much worse. When I move looks like platysma has been pulled forward and is maybe tenting skin up, but could this be submandibular glands that have fallen due to platysma being pulled forward? Definitely was not like this before, had tight jawline in this area. How hard to fix?

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photograph.

In general, it is difficult for the platysma muscle to create contoured irregularities as it does not have enough thickness. It is more likely that tensioning the platysma towards the midline has changed the way it drapes over the submandibular glands.

If the surgical intervention involved also liposuction, the skin compliance has also changed and drapes over the contours of the neck more intimately. This leads to increased visibility of the contour irregularities.

To address a concern of this nature, the most common approach would be to revise the anterior necklift procedure using a deep plane approach. It is likely that if the submandibular glands are reduced the digastric muscles also needs to be reduced to produce a smooth contour under the chin.

There are anecdotal reports of botulinum toxin treatment to the glands to reduce them but I am not aware of any structured scientific study that supports this treatment protocol.

Zoran Potparic, MD · Answer

This type of deformity is frequently seen as a result of platysma bands and possibly submandibular gland bulge. It is impossible to transect platysma muscle entirely through the anterior neck incision and, for that reason, active platysma muscle can create thick bands like yours, in some patients. Treatment with Botox may diminish this "deformity" but it will not eliminate it entirely. If this continues to bother you, you should consider posterior extended neck lift, where scar is placed behind the ear; this allows full transection of platysma, if needed ,and some skin tightening, which you do not seem to need. Hope this helps. Good luck.

Darryl J. Blinski, MD · Answer

In 1 posted photo appears as sub mandibular gland is exposed. The best easiest surgery is the MyElevate neck suture techniques. Fees $5,000. Best to virtual consult with...

Platysma muscle pulled forward or submandibular gland? (Photo)

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Platysma muscle pulled forward or submandibular gland? (Photo)

Answers (3)

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Our mission is to create a world where every investment in modern beauty is Worth It.