2 months post op Facelift/necklift with platysmaplasty. Platysma bands clearly coming back. (Photos)

Hello.  Thank you for your question.  It certainly appears that you have some recurrence of platysmal bands in the neck.  Unfortunately, this can occur in the hands of any facelift surgeon, and can be quite frustrating for both the patient and the physician.  The best way to prevent recurrence of platysmal bands, in my opinion, is to perform a midline platysmaplasty at the same time as the facelift with complete undermining of the cervical (neck) skin flap so that the skin can be properly redraped over the recontoured neck and jawline.  A lot of surgeons these days are performing less invasive "minilift" procedures that don't involve the work in the neck and can result in disappointing outcomes in patients with significant neck laxity and platysmal bands.  However, platysmal bands can also recur, even in patients where a platysmaplasty was performed.  A revision platysmaplasty procedure can be performed through a small incision under the chin, which should be helpful in resolving this issue for you.  This procedure can easily be performed in an office based setting using local anesthesia with, or without, light sedation using oral medications.  General anesthesia is not necessary for this type of procedure.  I would suggest waiting until you are at least 6 months postop prior to performing any revision procedure.  I wish you the best in achieving your aesthetic goals.

The key component to prevent or minimize any platysmal band recurrence is to open the neck with a submental incision and plicate or suture the muscle together and release it inferiorly .  However, even in the best of skilled hands, one can have a occasional  recurrence so you need to wait for at least 6 months before considering an operative revision    Make sure you select a board certified Plastic Surgeon with expertise and skill in the modern concepts of  facelift surgery 

Hello and thank you for the question. You benefit from platysmaplasty, which can be done under local anesthesia with or without sedation. It's best to wait a little longer prior to having a revision surgery. Your surgeon is the best resource to guide your through this process. Best,Pejman Aflaki, M.D.Johns Hopkins-trained plastic surgeon 

The return of these bands can come from a number of reasons.   If a platysma plasty in this area needs to be corrected, it can be performed under local anesthesia.  However you would want to wait several months to allow the tissue swelling from your first surgery to soften, if the neck was previously dissected.  If it wasn't, then you may be able to go back sooner. 

It is possible to correct this with an incision placed under the chin only.  The platysma band is dissected and sutured to the opposite side.  The procedure can be performed under local anesthesia to avoid the need for more involved anesthesia.  

It does look like you have some recurrent bands.   At about 6 months, if you are feeling well enough, these can be addressed through an incision under the chin with just local anesthesia.  Should be able to tighten the bands and skin to improve the appearance.  Botox can be helpful until you want to do that.  

Unfortunately, platysma muscle bands can re-appear after a face and neck lift.  The are very thin muscles that sometimes pull apart after repair.  I have been somewhat successful performing a neck lift just under the chin to stitch them together again.  I have done this in the office but I wait six months after the facelift to perform this fairly simple revision.Your health comes first so avoid any elective surgery until you health improves.Dr Spies

Thanks for the question, based on pictures looks like that you have minimal amount of platysmas bands. without pre operative pictures it is hard to say how much improvement you had. you can temporize it with Botox or get a revision surgery (possibly under the chin incision) when you are medically ready for it. good luck !

Hello, 
    Thank you so much for your question! Many many different surgeons offer facelift now days and many offer impressive results with less invasive proceedures such as skipping the midline platysmaplasty through an incision under the chin. In my experience this is a crucial step to skip leaning patients such as yourself unsatisfied. I would recommend letting things stabilize until you are 3-4 months post op. At that time a minor revision with a limited platysmaplasty should do the trick. If your contraindications are to Anesthesia, this could be competed under local Anesthesia or very light sedation in an outpatient ambulatory setting. I hope that helps and best wishes on your upcoming proceedures!
Dr G

I would wait for a couple more months for the tissues to soften. Then a proper re-treatment of the bands via only the incision under the chin should work. It is important to get the op note from the surgeon who did the original surgery to know what was done initially to plan the new treatment.best of luck!