I'm 65 and have a thin neck, however, my platysmal band is curling forward on the edges. (Photos)

Question

This is making two vertical ridges from under my chin to almost my clavicle. Can the platysmal be pinned down to remove the ridges?

Larry Weinstein, MD · Answer

I like nueromodulators (Botox or Xeomin) that relax the muscle band as an easy 5 minute office procedure. A neck lift from posterior ear incision can lift the bands laterally and up. The bands can be cut . An anterior below the chin incision is an alternative to access them and fix them. Good luck...

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may
benefit from a neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your neck.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Toby Mayer, MD · Answer

Platysmal bands and thin skin. You can try Botox first. If that doesn’t give you the results you want then a facelift with necklift is needed. This is best done by a very experienced facelift surgeon.

Jason Emer, MD · Answer

Some people require surgery to get the best improvement.  Non invasive options for improvement include:
thermage radiofrequencyultherapy high intensity ultrasoundPDO nova threads or  instalift for liftingsculptra injections for collagen productionbtl exilis ultra, venus legacy, and thermi250 for constant collagen stimulationJ plasma or thermiRF internal tighteningI recommend getting a formal evaluation with an expert. Best, Dr. Emer

Steve Laverson, MD, FACS · Answer

Yours are sharp, and of course could be resolved permanently by necklift, but I believe would respond nicely to neuromodulator (Botox, Dysport, Xeomin) treatment.

Zoran Potparic, MD · Answer

This is very difficult problem in neck rejuvenation. In a skinny neck like yours, that doesn't have any fat to cover/camouflage subtle platysma muscle deformities, it is hard to find an universal answer. Tightening platysma muscle in the anterior neck all the way to jugular notch (platysmoplasty) solves the problem but creates a thick scar band in the middle visible for several months. Treatment with Botox works well for muscle bands only; it may be the way to start your treatment. Good luck.

William Portuese, MD · Answer

A thorough examination of the neck is required to make the appropriate recommendations without how to proceed.  A lower face and neck lift procedure can accomplish tightening loose facial and neck skin, and performing a platysma plasty.  The platysma plasty itself involves tightening the platysma muscle underneath the chin, and releasing the active platysma bands lower down in the neck.

David Reinstadler, MD · Answer

The banding you are experiencing is a bit too far apart for a standard platysma plication to help. you would need a full neck lift to tighten the platysma muscle from the sides but I think botox injections would be the best first step to see how much they will help. It is quick with no down time and you can always do something more invasive If you are not happy with those resultsBest of luck

Edward J. Domanskis, MD (in memoriam) · Answer

Yes, the platysmal bands are what is atempted to be helped with a platysmaplasty. I do these procedures even under a local anesthetic wit minimal down time.

Val Lambros, MD, FACS (retired) · Answer

this is not an easy problem. It's not just the animating platysma bands...... the skin over the bands has been stretched, in addition there is no fat for camouflage.  There is a high incidence of recurrence with whatever you do. I would try things like botox first, which may help a little.  Standard platysma maneuvers work less than 1/2 the time at a year in my opinion

I'm 65 and have a thin neck, however, my platysmal band is curling forward on the edges. (Photos)

Answers (10)

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