My platysma muscles have separated and the tendons in my neck are ugly when I smile. I'm only 47, why has this happened? (Photo)

Thanks for your pictures- what is happening when you smile is that your platysma muscle tenses causing it to be visible. The middle parts of the platysma has separated. You have two options to help with this. The simple and quick one would be to have botox placed into the muslces there, this would prevent it from tensing and becoming obvious. The benefit of this is that its quick and should last about 4-6 months. The other more permanent option would be to undergo a neck lift. This is done through an incision under your chin, with or without incisions around your ears- this would have to be determined on examination in person to see how much loose skin is present. 

Dear mmrh:By the looks of your picture, you have separation of the platysma muscle along the central portion of your neck and banding of the same muscle on either side.  A platysmaplasty usually works in this case but this consists of incisions along and within the hairline and a central incision under your chin.  If you are someone with Keloids, then you might want to try something less invasive such as chemodenervation with Botox first.Hope this helps!Good LuckDr. E

Good morning Mmrh, Thank you for your very valid question. This finding is very common in slimmer build people, (also who might often do sit-ups too). Fortunately for us all, there are several  successful treatments available for this, ranging from completely non-invasive, to micro-invasive, to fully surgical. It is best that you be evaluated in person by a Board Certified Facial Plastic Surgeon who is well versed with all of the above (not just one or the other) so that together you can determine what would be the right procedure for you, after your neck and face are thoroughly examined. My personal preference is to follow the non-invasive route, yet all are options. Many providers are unaware of the fact that the platysma connects  to the facial musculature and that needs to be taken into account as well.I hope this information has been helpful for you - it is easy to eradicate the platysma bands, but a discussion of the pro's and con's  and a thorough examination must ensue first with your Specialist. Best Wishes in your quest, Dr. Anna PetropoulosBoard Certified Facial Plastic SurgeonDanvers, MA

A full set of pictures at rest, not upon animation are required to make a determination about what surgical procedure would be necessary. The 2 anterior platysmal bands and the sewn together with a platysma plasty, and in addition releasing of the bands can occur down low in the neck.  In our practice, we have never seen a keloid in the submental incision. Depending upon the skin tone, a neck lift or a face/neck lift may be required.   For many before and after examples of the neck lifts performed in our practice, please see the link and the video below

About one third of the population will be born with this condition of platysmal muscle separation.   Botox can be used to treat this but surgery is the best solution.  This is usually part of the facelift.  It requires an incision under the chin which is usually obscure.  Although it has been done without removing  skin peri auricular (around the ear), but is not nearly as effective in most cases as doing with the facelift.  The cost will vary widely.

Thank you for the photos and the question and the procedure you desire is a necklift with a platysmaplasty.  So see some experts in your area and be evaluated.Dr. Corbin

This is actually pretty common in a thin woman your age. It may be hereditary also.  Botox can help but only lasts about 3 months in this area.  A procedure called a submental platysmaplasty can improve it and is very long lasting.  The surgery can take less than an hour.  I have attached a link,