What are risks of platysmaplasty without lateral fixation?

Question

For a young, thin neck with visible platysma bands in front, is it advisable to do a platysmaplasty in the front with no lateral incisions? Or are the lateral incisions necessary to prevent the sutured area from pulling tissue into the front of the neck/submental area or from pulling forward lateral platysmal bands? What are other risks of midline work without lateral incisions? How often is only midline work indicated for younger necks?

David Parizh, DO · Answer

For a young person, with good skin elasticity a submental incision alone to address the deep neck structures and platysma should be sufficient. The deep neck work includes assessing the need to address the submandibular glands, interdigastric fat and digastric muscles. You would then redrape the skin and address the platysma. I would need to examine photos to guide further. A good surgeon who is comfortable with addressing all aspects of deep neck work is key to cater an approach to your needs vs a turn key approach. Best of luck! Let me know if I can help answer any questions further.

Michele A. Shermak, MD · Answer

Hello!
Typically the platsyma is managed under the chin and around the ears, moreso in the back of the ear for a neck procedure. Oftentimes the muscle needs to be suspended up along the sides to improve tautness and smooth the neck skin so it is not "bunchy". There is no "one size fits all" and your case would have to be evaluated to assure treatment of bands and a nice smooth neck.
I would recommend you see a board certified plastic surgeon to examine you and come up with a strategic plan. You can find one at plasticsurgery.org.
Best of luck to you!

Zoran Potparic, MD · Answer

In the neck that is without significant laxity and fat deposits, anterior neck lift may be a good solution (incision underneath the chin). However, if skin laxity is expected after platysmoplasty, this redundancy of skin must be addressed with skin excision in a form of face/neck lift or extended posterior neck lift. Hope this helps.

Philip S. Schoenfeld, MD, FACS · Answer

With the very limited information that you have provided I will give you my two cents.  A midline platysmaplasty without significant redundant neck skin may be all that you need to address your platysma bands.  If you have neck skin laxity then you will need the incisions laterally to redrape the excess skin.  The answer can get a great deal more detailed than what I have provided but a consultation would be necessary for that.

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! Great questions. If the skin is young with good elasticity and the bands mild, you may be able to get away with a submental incision only without anything laterally. The benefit of the lateral extension is that the full neck can be treated and the tension dispersed evenly including via skin removal. When the midline neck is pulled tight, the skin needs somewhere to go. If there's laxity, it needs to be removed laterally otherwise it will hang in the midline. Hope that helps!

William Portuese, MD · Answer

Much more information is needed, such as a full set of facial photographs from all angles, your age, and the status of the skin tone in your neck. Depending upon your age and skin tone, a neck lift versus a lower face and neck lift may be required. With a neck lift, only a single platysma plasty performed. With a lower face and neck lift, lateral fixation is performed on both sides of the neck in addition to the Central platysma plasty

What are risks of platysmaplasty without lateral fixation?

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