Is there any surgery that addresses prominent platysma bands? (Photos)

Question

I had a DPNL and DPFL 6 months ago. My platysma bands are still prominent and are visible in photos. Furthermore, I still have crepey neck skin (essentially unchanged). My surgeon said these issues originate from the lower neck and are not involved in the surgery. Is there any surgery that does address these issues? Thank you!

Carl Truesdale, MD · Answer

Platysmal bands are one of the most surgically responsive aging changes in the neck, so this is treatable.
The operation that addresses them is a platysmaplasty, which can be performed alone or as part of a neck lift. There are two main types and the right one depends on band severity.
Anterior platysmaplasty (also called corset platysmaplasty) approaches the bands through a small incision under the chin. The medial edges of the platysma muscle are sewn together in the midline, which eliminates the bands and creates a cleaner neckline. This is the workhorse for moderate banding.
If you also have skin laxity or jowls, the platysmaplasty is combined with a lateral neck lift or full deep plane facelift. The lateral component pulls the platysma backward toward the ear, which gives more powerful jawline definition and addresses the loose skin at the same time.
A few things worth knowing.
Botox is sometimes offered for platysmal bands. It works for a few months but isn't a long-term solution and can't fix loose tissue.
If your bands are visible mainly with animation (when you grimace or talk), a smaller intervention may suffice. If they're visible at rest, you almost certainly need surgical correction.
Anterior platysmaplasty alone has a shorter recovery than a full neck lift, but it doesn't address skin envelope. So if you have any loose neck skin alongside the bands, the combined approach gives a better result.
Best next step is an in-person consultation where the surgeon can grade your band severity and skin quality. A photo gets you partway, but the platysma needs to be palpated to plan accurately.

Philip Wasicek, MD · Answer

Hello, 
Persistent or recurrent platysmal bands, and neck laxity can occur after a face/necklift. 
The platysma muscle has multiple segmental innervation and can be tricky to treat. Sometimes the answer is continued neurotoxin (such as botox). However, there are multiple types and techniques of necklifts that have greater chances of addressing your concerns--especially in the face of recurrent platysmal banding and/or skin laxity. Specific procedures such as lateral skin-plastysma displacement necklift or platysmal myectomy/z-plasty can have a better chance of treating these issues. Not all plastic surgeons perform these types of necklifts. Some of these newer and more advanced techniques do result in greater improvement in the neck compared to more traditional techniques. 
I would suggest you be evaluated by a board certified plastic surgeon who specializes in facelift/necklift including revisionary surgery. 
Hope this helps.

Is there any surgery that addresses prominent platysma bands? (Photos)

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