When and Why Do Platysmaplasties Fail?

Question

I had a platysmaplasty and lower facelift 3 weeks ago and I still have persistant bands showing. I am 46 yrs old, I do not smoke and have good skin elasticity. I feel very dissapointed,can anything be done to get rid of theses bands? Thank you

Otto Joseph Placik, MD · Answer

The management of platysma bands is controversial. Some surgeons advocate an anterior platysmaplasty or platysmorrhaphy while others prefer partial or even complete transection of the bands. Many surgeons favor complete abandonment of the anterior approach with a posterior approach as their preferred option. Failure can be due to a number of reasons ranging from technique, wound tension (too much or too little), animation tendencies, suture pull through or ("cheese wiriing) or excessive tension, etc,

Stephen Prendiville, MD · Answer

Although it is very hard to give a diagnosis without more information, early failure of platysmaplasty is most likely technical. As with anything, with a wide variety of Surgeons, there will be a wide spectrum of results. Whether of not the plastysma was correctly sutured, what type of suture was used (I favor long acting absorbable suture such as PDS), and the animation strength of the platysmal muscles may all play a role.

Steven Wallach, MD · Answer

It is difficult to say why you have platysma banding three weeks after surgery. It is always key to knwo what was done in surgery to attempt to eliminate the bands first and then one can go from there.

Richard Sadove, MD · Answer

Persistent bands 3 weeks after surgery are almost always due to the surgeon having not sutured the platysma muscle together in the midline. It is most commenly the result of fat on top of the muscle which obscures the surgeons view of the muscle. If you did not have an incision under your chin, you likely did not have a platysmaplasty. In my opinion, medial bands can not be reliably and significantly corrected without suturing the muscle together via the incision under your chin. "Pulling" from the side is an overly optimistic shortcut which I do not believe stands the test of time.

	Now the issue is what to do. The good news is that you do not have to have your entire facelift redone. The bad news is that you need to go back to surgery and have the muscle sutured together via the incision under your skin. I dont think you need to wait 6 months.

George J. Beraka, MD (retired) · Answer

Hi.

	Hard to answer your question.  Either you were not good candidate or surgery was not well done.  Wait 6 months and then consider a revision.

When and Why Do Platysmaplasties Fail?

Answers (5)

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