How long for prominent platysma muscles and scar tissue to abate? 6 months post Face lift. (photos)

I had a smas facelift (no liposuction) in March. After 6 months, I suffer from prominent platysma neck bands, tightness, and a shrink wrap feeling of the skin in the neck. I had none of these issues before facelift. PS says this is induration, that the muscles and skin are remodeling which will resolve on its own over time. It seems to be getting worse- not better. PS says that he did not cut any of the platysma muscles so the tightening is due to inflammation or scar tissue. Thoughts or advice?

Doctor Answers 16

Neck bands

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Thank you for posting your questions. Even though your body should still be readjusting and reshaping itself six months after the lift, your photos do show plastymal bands and separation of plastyma muscles. A revision procedure may be needed, but botox injections can also help in the meantime. I recommend consulting in-person with an experienced, board certified physician. Best of luck.

Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Neck bands

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At 6 months post op, your swelling and inflammation should be fairly stable. I would suggest that you schedule another appointment with your surgeon to discuss your options. It looks as if you may need some work done on your platysma muscle to release the tension. 


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 38 reviews

How long for prominent platysma muscles and scar tissue to abate? 6 months post Face lift. (photos)

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At 6 months after surgery your surgical result is pretty much stable. It appears that you need to have further work on your platysma muscles. Speak to your surgeon to see if he/she will do a revision for you. Your result can be corrected.

Warren J. Katz, MD
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 19 reviews

Neck Bands

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Neck bands after a facelift can be caused from scar tissue or tight platysma muscle fibers. After looking at your photos, it appears to me that most of the problem is from scar tissue as your doctor has explained. Deep massage, while stretching the neck can help soften these bands. Kenalog can also be injected into the bands which often dramatically helps to soften this scar tissue. If these conservative measures fail, then retightening of the SMAS laterally without elevation of the skin over the scar tissue can be very effective in making the bands less prominent. 

Visible neckband six months after face and necklift surgery.

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If your photos were not taken with you clenching your teeth and the bands are this prominent in repose you almost certainly are going to need revision work done to cut some of the muscle bands and plicate the platysma either toward the midline or as I prefer laterally.  Injection of Botox will be a temporary and possibly dramatic improvement for you but I would suggest that you obtain your operative report and seek opinions from ABPS board-certified plastic surgeons.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

How long do platysmal bands last after a Facelift

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Thanks for your question. At 6 months, if you see any banding, my opinion would be that it is permanent. Typically, when we do a neck lift and platysmaplasty, you should see no edges of the muscle or at least very minimal edge. If the surgery does not work perfectly, you can sometimes start to see the muscle again. 

In my opinion, a revision surgery would likely be required to correct this. 

Dr James Bonaparte

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Ask your surgeon when are you considered healed

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and when can you critique results so that revisions can be undertaken to improve upon your results?  You look like you had aggressive liposuction under your jawline.  And you do have separated muscles that may be 'indurated' but at 6 months, most of your inflammation is gone.  Find out what your surgeon's revision policy is and ensure he is properly credentialed.   Get a formal second opinion if you want some objective advice and recommendations.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Platysmal Bands

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Thank you for the question and photographs.  Your platysma muscles are separated.  Occasionally skin bands without platysmal bands can occur   from scarring, and you appear to have some element of scarring on the first photograph.  A trial of botox is reasonable, but you will likely need revision surgery to suture the edges of the muscle together.  I hope this helps and good luck.

Raj P. TerKonda, MD, FACS
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Neck bands after facelift

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Best way for you to evaluate this is to see if the skin glides over the muscle when you move it with your hand. If it moves easily, I would just use some Botox injections into the cords. If not, I'm thinking that even without liposuction in the neck area, you probably had a good deal of undermining to lift the skin off the platysma muscle, which is commonly performed. In that case there may be some residual inflammatory scar contracting of the skin to the muscle. I would recommend some very dilute Kenalog mixed with Hyaluronidase (to help spreading the Kenalog along the under-skin space) injections to the area. Then have some Botox injected directly into the bands. It will improve, I'm fairly certain.

Norman Leaf, MD
Beverly Hills Plastic Surgeon

Revision facelift with platysmaplasty

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There are different approaches to platysma bands in the neck, but in your case I would not expect further improvement at 6 months post op. A revision with platysmaplasty might be considered, and this would include sewing the muscles together, cutting them horizontally to disrupt the bowstring effect, or both.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.