Platysmal Banding After SMAS Facelift, Is This Normal?

I am just short of 3 months post SMAS facelift. I had an incision under my chin and around my ears. So far, healing seems to be going well; however, I now have tightness when I lift my head to look up at things AND I can see my platysma muscles (like vertical bands) when I stretch my neck back. Is this a normal part of the healing process? Will it resolve in time? If not, what can be done to correct this?

Doctor Answers 9

Tightness and Platysmal Banding after SMAS Face Lift

The tightness that you are experiencing in your neck should continue to resolve with time.  You may want to add some massage of the area to accelerate it loosening up.  It is difficult to assess the platysmal bands without a picture.  Later options may include some Botox versus re-entering the neck and dividing the platysma low in the neck and bringing it together in the midline.

Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Platysmal bands after a facelift

In general, I would expect your tightness to resolve on its own. The bands, however, are unlikely to spontaneously disappear. In my experience, a full Feldman corset is the most reliable treatment for platysmal bands. While it is a great operation, it generates a very significant healing process - much more than simpler approaches (which fail to address the bands as completely).

I would allow full healing, then seriously consider how much ground you've gained from where you started, and if a major revision is warranted to go after the bands. If so, visit an experienced neck lift surgeon.

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 198 reviews

Rate of platysmal bands after facelift

Platysmal bands can recur at a high rate after a facelift despite performing a platysmaplasty (sewing of the bands together). Unfortunately, this is the nature of this type of operation.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

SMAS really has nothing to do with platysma banding after facelift.

The SMAS ends at the jawline so doesn't really have much to do with platysma banding repair.  The platysma and the SMAS comingle at the jaw but have no relationship down the middle of the neck.  Surgical correction of the muscle eliminates or reduces the visible bands.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Platysma Neck Bands

Tightness and bands especially when you tilt your head back are common after SMAS facelifts. A platysmaplasty (sewing the bands together) eliminated the bands post operatively but you would still complain of tightness. This should go away in the ensuing weeks ahead.

If for any reason the vertical plasysma neck  bands are still tight you can consider a platysmaplasty.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Platysmal bands after Facelift

Tightness in the neck post SMAS facelift is common. This slowly dissipates as the months go on. When you near the four to five month range you should have proper mobility. It is difficult to give you and answer regarding the platysmal banding with out a photograph and not having a copy of your operative report. I would suggest going in to see your surgeon and discuss your concerns. Hopefully he/she will be able to give you some definitive answers. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

The "Bands" Play On

 Usually if the neck is part of the treatment plan and platysmal bands are identified then correction should be accounted for during the facelift. A common strategy would be to sew the edges of the bands together and partially divide the bands horizontally to allow for better neck contour.  I would discuss your concerns with your PS to see the strategies available for you.

Good Luck

Dr. ES 

Platysma Banding after SMAS Facelift

Tightness of the neck can persist for several months after a SMAS lift  because of stiffness in the platysma muscle. This will resolve. I cannot comment on the appearance of vertical bands without a picture. You can send pictures or just ask your surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Playsmal Tightness after Face and Neck Lift

  Usually, the platysmal tightness subsides with time.  Tissues always relax in the face and neck lift even if permanent sutures are used.  Massage will help along with tincture of time, but your plastic surgeon will be your best source of information for this as he or she knows how the techniques employed affect recovery in his or her patients.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

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.