Platysmal Banding After SMAS Facelift, Is This Normal?

Question

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?

Babak Azizzadeh, MD, FACS · Answer

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.

Kenneth Hughes, MD · Answer

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

Vincent N. Zubowicz, MD · Answer

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.

Larry S. Nichter, MD, MS, FACS · Answer

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.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

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

Laxmeesh Mike Nayak, MD · Answer

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.

Michael Sundine, MD, FACS · Answer

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.

Michael Elam, MD (retired) · Answer

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!

Richard W. Fleming, MD (retired) · Answer

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.

Platysmal Banding After SMAS Facelift, Is This Normal?

Answers (9)

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