My neck platysma muscle bands are very visible 7 weeks after necklift (photo)

Question

7 weeks ago I had suction lipoplasty of the neck (which was barely needed)- a submental incision was made and the platysma bands were sewn together w/ 3-0 PDA. I also had a lower s-lift (mini facelift). My platysma bands are visible now that the swelling is gone. The point of the surgery was to correct this- what do you think went went wrong? What would be the next step in your opinion?

Alejandro J. Quiroz, MD · Answer

The fact that you had suction the fat under your neck causes that the muscle to be more visible. Some fat in the neck is important to maintain to cover the muscle. Now the picture was taken with a contraction of the muscle I wander how it looks without the contraction because is important to recommend the procedure that will be more appropriate

Stefan Mark Szczerba, MD · Answer

A formal neck lift with plication of the neck bands together called a "corset plastysmaplasty" usually solves this issue.  It's definitely not a "mini lift" however minilifts alone usually get only subtle results.  Best Wishes!!

Philip S. Schoenfeld, MD, FACS · Answer

It appears that you have two very prominent platysma bands.  They are basically the medial bellies of the platysma muscle that have separated.  It also appears that you may be contracting the muscle which will make them more prominent.  Unfortunately, a mini facelift  procedure will not improve the platysma banding.  Your banding is significant enough that a formal platysmaplasty would need to be performed.  A lateral neck lift in conjunction with a submental incision may be required depending on the neck skin and platysma laxity.

Brian K. Machida, MD, FACS · Answer

It looks like he corrected any bands in the submental area in the upper half of the neck.  The bands in the lower half of the neck are difficult to correct because of limited access.  In order to improve the situation, more extensive lateral neck incisions could be considered which might not have been part of your mini lift.  Its best to see your surgeon for follow up.

Dilip D. Madnani, MD, FACS · Answer

Thank you for your after picture. Are you flexing your neck muscles in these pictures ? do you have a picture of you flexing before the procedure that we can put next to this one ?  or even better, do you have front and quarter profiles of your before and afters in a resting pose.  I think those would be best to see exactly what is going on as while flexing, it really tends to exaggerate the muscle separation, all of the docs pictures on this site and websites show patients befores and afters in a resting pose. Lets see those and we can make better judgement of the results from there.

Jeffrey M. Darrow, MD · Answer

Your photos appear to show 2 separate platysma bands in your neck.  After the suturing of the medial playsma bands, these should not be there.  You may require a revision, with resuturing of the platsyma both medially and laterally.  Follow up with your plastic surgeon and express your concerns.

Anna Petropoulos, MD, FRCS · Answer

The appearance of platysmal bands happens to all of us as we age and the appearance can sometimes be accelerated after liposuction. We all come to the point where we need Botox in our platysmal bands at some point of time or other. Your muscles seem to be very strong and maybe the PDS popped. Your bands should  be very amenable to a Botox treatment. In addition you could performa a Fractora skin retexturing procedure for the neck and chest and also apply Defenage and Sente to your neck for further enhancement of  the robustness of your skin. 
Best Wishes, 
Anna Petropoulos, MD, FRCS
Board Certified Facial Plastic Surgeon
North Shore Boston

Jonathan Kulbersh, MD · Answer

It's still early in you recovery. I recommend following up with your surgeon about after care. Try Botox to soften your platysmal bands and chemical peels to improve the quality of your skin and, one hopes, restore a bit of elasticity. I hope this helps.

Gabriel Kind, MD · Answer

The platysma bands appear to have separated from the midline repair that was done. If Botox does not improve the appearance, revision surgery with partial or complete division of the platysma, along with suturing the medial edges again, would be likely to result in improvement. Best of luck!

Jesse E. Smith, MD, FACS · Answer

It is possible to make a small incision under the chin and correct these areas again.  this would include bringing the bands back to the midline by elevating on either side of them, and employing a 3-0 PDS or nylon suture to bring them back to the middle and bind them together.  I usually place a suture at the hyoid bone as well, in order to recreat a 90 degree angle at the neck so you look amazing during profile views.