I Have Very Prominent Platysma Banding That Shows Up when I Smile, Talk, Eat. My Options?

There is a little confusion with answers to your question, because the terms surgeons use are not standardized.  In other words, most facelifts (vs minifacelifts) really mean anterior platysma plication using an incision under the jawline, and repositioning of the platysma and SMAS  from the lateral approach that tightens the neck, jawline, and cheek soft tissue.  So in my opinion, the term of an isolated neck lift is just a made up to sound more direct for patients.  What is done to the platysma in a facelift depends on the extent of banding and the surgeons preference.  Most docs will remove some of the redundant muscle component near the midline, and secure it to the platysma from the other side of the neck with sutures.  Usually a little back cut on the leading edge of the lower muscle also helps camouflage the bands post op.  As Dr Mayer notes, he may cut all the way across the lower muscle, which can be indicated for patients too.  I know some surgeons will advocate removal of the glands, even if done endoscopically, but I would not suggest that either.  Its a complicated procedure that is difficult to do through the more distant incisions a facelift utilizes.

I also think that a submandibular gland will be more visible post facelift in some patients, and  less in others. It depends in part on their anatomy and skin thickness. Discuss that issue with your surgeon.  #facelift

It would be best to consult with a board-certified surgeon in-person as you may have more than one option. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. Chin deficiency with the neck and jawline are also taken into consideration. A weak #chin implies a lack of chin support for the skin along the neck line. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
Patients who desire facial rejuvenation that is affordable, quick, and effective should also consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift, individualized for each patient, that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern. 

Platysma bands are best treated in my 35 years of facelift surgery by excision and a facelift at the same time to take up the excess skin. Excision of the submaxillary gland carries to much risk, so leave them alone.

Options for platysma banding range from Botox treatments to a lower face and necklift. Botox is obviously temporary and the results last about three months. While surgery is more involved the neck rejuvenation should be permanent. Drooping submandibular glands are a challenging problem. A platysmaplasty will tighten the tissue and muscle around the glands but sometimes they are still somewhat prominent following a necklift. Sutures can be used to tuck the glands back up where they once resided under the jawline. I hope this information is helpful.Stephen Weber MD, FACS

It is very difficult to minimize the size of the submaxillary (submandibular) glands without going in and removing a portion of it and this could result in dry mouth, and is not acceptable.  Anterior platysmal bands are best addressed with platysmaplasty with transection of the bands down low in the neck all through a submental incision.  If there is any excess skin in the neck a lower face/neck lift will have to be performed, not just a neck lift.

A neck lift or facelift (depending on your overall needs) with a platysmaplasty done as a part of the procedure would take care of most of what you describe. The submandibular glands are usually pushed upwards slightly as the platysma muscle in the neck is tightened, improving mild bulges due to the glands. If the glands are really prominent, a portion of each gland can be removed safely during the neck or face lift, giving a nice smooth result. If it is only the bands that are an issue at this time, you could even consider Botox as a temporary improvement. Good luck.

Most patients with platysma bands would benefit from a facelift or neck lift with a platysmaplasty. Submandibular gland partial or full resection has a high risk of major complications. Submandibular glands can appear more prominent after a platysmaplasty, sometimes. Find a board certified plastic surgeon to discuss your options.

There are a number of options. If the banding is mild you can try less invasive options such as thermage, ultherapy, or botox. If the bands are more prominent you may need to address them surgically. Surgical options include a simple platsymaplasty, a formal neck lift, or a neck lift combined with a facelift. Prominent submandibular glands are very difficult to manage. Occasionally just doing a neck lift will elevate the glands into a less conspicuous position. There are also suspension techniques that can be used. Regardless, it is difficult to get a perfectly contoured jaw line when the submandibular glands are prominent. I would visit with at least two qualified and experienced surgeons and compare opinions.

You have several options for prominent platysma bands, including simple Botox injections (lasting about 4 months), to submentoplasty to full face and neck lift procedures, which last many years. Your age and the degree of existing jowling/ neck laxity will determine which procedure is best. I do not feel that excision of submandibular glands is wise, and can lead to many complications, including deformity, nerve damage, dry mouth, and dental problems.