When and Why Do Platysmaplasties Fail?

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,

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.

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.

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.

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.