Do I need revision platysmaplasty 15 months after my lower facelift? (Photo)

Thank you for your question.  It appears from your photo that you have platysma bands but a proper assessment requires an in person examination.  I think it is reasonable to expect that a facelift would address platysmal banding on a long term basis (at least several years if not permanent).  I would suggest discussing your original goals and expectations with your surgeon.  Correction might require an incision below the chin depending on their preferred technique.  They may have taken a more conservative approach with the initial surgery to spare you this incision but looking back they may agree that more work could have been done on the platysma.  
Surgeons are often trying to deliver the results you seek with the minimum invasiveness to balance healing, swelling, visible scar.  Surgery is a form of injury to tissues and philosophically there are many judgement calls during surgery as we work to get the best result for you.  Sometimes (in retrospect) we have erred on the side of caution with less undermining, less release of tissues and less incisions.  Sometimes patients imply they want a less invasive surgery (lower facelift or neck lift versus standard facelift, breast implants without a lift, mini rather than standard tummy tuck) and this compromise in invasiveness/cost can lead to less correction than hoped for.  One of the hardest things for surgeons is trying to explain why the more extensive surgery is the better choice given a patients individual goals without sounding like we are trying to upsell the patient.  
If your original consult dealt with skin laxity and jawline contour only, then you have a nice result. If you specifically discussed platysmal banding and your desire to have that corrected, then the surgery does not appear to have succeeded in that respect and a revision is something to consider.  You may find the original surgeon is willing to do this for you at minimal to no additional cost, or you may need to seek a second opinion from a reputable board certified plastic surgeon in your area.  Again - I am basing my comments on a single static photo and a full in person exam is the only way to properly review your situation and properly discuss any further options.  Good luck and I hope things get resolved to your satisfaction.

Platysma bands can recur even after well-performed surgery. I have used two main techniques: firstly, notching each band low down and then stitching together the bands to create a smooth 'corset'; or completely cutting through the band on each side, and pulling each muscle with strong sutures back toward the ear. I have used the second technique only for the last six months, but I suspect it will prove to be better than the corset. In any event, the surgeon does need to do something apart from simply pulling from the back, to deal with these cords. I deal with revisions as follows: I do the surgery at no charge to the patient, who does pay the clinic and anesthesia fees. I recommend you have a good talk with your surgeon. All the best.

Neck lift surgery can be somewhat unpredictable at times. My guess is that your surgeon used a lateral approach to resolve the excess skin/muscle laxity, which worked for a few months but then the platysmal bands reappeared. At this stage, you would benefit most from a submental approach +/- lateral approach with a thorough platysmaplasty to reduce the chance that the bands will return. Prolonged neuromodulator use is not a great strategy. As for cost, patient would pay for facility +/-anesthesia but not for my time.
Gary Linkov, MD
Neck Specialist
Manhattan