Still Have Plastyma Bands 4 Months After a SMAS with Submental Platysmaplasty?

I cannot use Botox . What other alternative are there to get rid of platysma banding? If Botox can be used to relax banding, then Is cutting them a possibility - Do they really serve any useful purpose? I'm sure there are a variety of reasons for the platysmaplasty failng, but can a repeat platysmaplasty be done successfully?

Doctor Answers 7

Platysma bands.

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Complete removal of the platysma bands with surgery can be dificult. It is possible to go back into the neck for a revision but I would suggest you waitn at least 6 months. The Platysma muscle can be cut and brought together in the midline. This may have already been done at you initial surgery but in some cases may need to be revised despite your surgeons best efforts.  Good Luck

Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Platysma issue

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If the bands did not improve then perhaps they need to be divided inferiorly as well. Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Repeat Platysmaplasty

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  A platysmaplasty can be done again, and platysmal bands can be released.  I would wait at least 6 months to determine if this will be necessary.  Kenneth Hughes, MD facelift Los Angeles, CA

Residual Banding following Platysmaplasty

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Final Healing Following SMAS Facelift and Platysmaplasty  is Progressive Over Many Months

Although 4 months have passed it is likely that it will improve at least somewhat over the next 6 months.Without seeing your photos or without an exam it would be impossible to tell, but a good question for your plastic surgeon. If it does not resolve by a year post op then it is likely to require a separate treatment option. Yes cutting the bands at their base may solve this problem and is an option to discuss with your plastic surgeon at that time.

Failed Treatment of the Neck

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BOTOX has been described in the treatment of platysmal bands but I do not recommend it.  Reoperation is a reasonable option.  I would wait at least 2 additional months before considering that option.  Lastly the many reasons for your first platysmaplasty failing (whatever they were) need to be corrected/addressed.


Dr. ES

Still Have Platysmal Bands After Facelift

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In my experience, there are a few options that can help with losseness under the skin after a facelift, the recurrence of platysmal bands, or residual fat that is left in the centeral neck space. I will list my experience with each option:


1. For extra loose skin in the submental space, the best non-surgical option for correction is Thermage or Ulthera. One can also use other RF devices or fractional lasers to some extend as well to tighten the last bit of skin in this space. On the minimally invasive surgical side, one good option is using SMART or SLIM Lipo at lower energies to tigthen the skin, taking care to not perform thsi if there is little to no fat left in this space. Surgically, while doing short T-Neck procedures are an option, I perfer redoing both the medial and lateral aspects of the facelift to pull out alot of skin laxity. The laser lipo systems are also excellent to loosen scarring in this space when combined with a new lift.


2. For extra left over fat, the best option here is laser lipolysis. Both SMART and SLIM Lipo systems can be used very effectively, along with some traditional liposuction to get the volume more even. If there are significant assymetriers, a new lift is in order.


3. On the residual banding issue, I have found that if the occurence is mild, skin tightening devices can help. By tightening the skin over the muscle, one can sometimes hide a slight band. Beyond this, I have found one good option using the Trampoline Lift Kit developed by Implicitcare and Dr. Gregory Mueller excellent to percutaneously cut across the muscle and weaken it at certain points. With skin tightening therapy on top, this can work. Finally, one may need a new lift. Here I again do the medial and lateral lifts first, but I find on secondary lifts using sutures like the 2-0 PDO Quill Suture (Angiotech) can help hold the bands together tighter and reduce future laxity.


I hope this information helps. Best of luck!!

Farhan Taghizadeh, MD
Phoenix Facial Plastic Surgeon


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A repeat platysmaplasty would probably improve your bands. However one need a good examination to dtermine the cause of your platysma bands. Occaisionaly fat grafting may be needed if the cause is skelotinizing the neck and removing too much fat

Samir Shureih, MD
Baltimore Plastic Surgeon

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.