Do I need surgery for this? Platysmal bands? (Photo)

Question

I have talked with a doctor about using Botox on these which he calls platysmal bands. They seem to come and go particularly when I lose weight. I have an underlying condition of the thyroid that causes me to lose weight. I am only 38 and When I talk the two in the front are moving, so it looks like they are firm. I don't know what to do? Do you recommend a surgery for this? Thank you!

Rian A. Maercks, MD · Answer

If Platysmal bands are your only concern, a neuromodulator is not a bad option.  The problem is that this can get very expensive if you repeat every 2-3 months.  If your neck silhouette is lax and you have other facial findings then I would combine the surgical treatment of these bands with a facelift.  If you want to soley address your neck, a sub mental incision can be placed (underneath the chin) and the neck and floor of mouth can be tightened while directly addressing these bands with transection and imbrication.  I hope this helps!All the best,Rian A. Maercks M.D.

Jed H. Horowitz, MD, FACS · Answer

hello iglowgirl A necklift is a surgical or non-surgical procedure designed to smooth out these wrinkles and folds that occur with age by tightening the tissues that lie beneath the skin and removing extra skin around the neck and jawline.  Necklifting methods are tailored to each patient to give their desired youthful result, reversing the visual effects of the aging process. #options #platysmal

Larry S. Nichter, MD, MS, FACS · Answer

Your platysmal bands are significant and I doubt that you will be satisfied with botox which will only work for a few months at a time. A platysmaplasty and neck lift seems to be indicated based on your photos. See below link for more details.

John Mesa, MD · Answer

Neckbands or platysma bands can create concern to patients
because they are related with unattractiveness or signs of aging. Depending on
the type and severity of the bands, they can be treated surgically or
non-surgically. Dynamic platysma bands ( the ones that “show up” on animation)
can be treated with neuromodulators like Botox. However, this of-label
treatment only last 3 to 4 months, therefore serial re-treatments are necessary
to maintain a long lasting result. . Static bands (those that are visible with
or without animation) can be corrected with a neck lift ( platysmaplasty). In
certain cases, dynamic bands can be treated surgically with percutaneous
platysmotomy). Patients interested in addressing platysma bands should undergo
a consultation with a Board Certified Plastic Surgeon specialized in neck
procedures.

Jeffrey M. Darrow, MD · Answer

There is almost no downside to treating your platysmal  bands with Botox to see how much better the appearance can be with this non-invasive modality..  If Botox corrects this enough then you can repeat it every 3-4 months to maintain the effect.  If Botox does not correct this sufficiently, you may consider a neck lift, where the bands can be treated surgically and likely will give you a excellent neck contour for years to come.  Best to discuss this in person with a board certified plastic surgeon of your choosing.

Timothy R. Miller, MD · Answer

There are two options for platysmal banding: Botox or a neck lift procedure that addressing the platysmal bands.At 38, and with minimal skin laxity, trying Botox maybe an effective, non-surgical treatment option for you.The attached link provides more information and the results of Botox to the neck.I hope this helps.

Scott A. Brenman, MD, FACS · Answer

For prominent neck bands, the treatment is generally surgical for a permanent correction. Through a small incision under your chin (sub-mental) the neck bands are sewn together (plicated) and then divided below the level of the plication. This is a "corset platysmaplasty" and can be done alone or incombination with more extended facelift procedures. Sometimes fat is removed above and below the muscle level, and sometimes the skin is also tightened if it lax. Use of botox may give some temporary improvement but it is short-term (around 3 months) and then the situation will revert back until it is surgically corrected.Best, Scott A. Brenman, M.D., F.A.C.S.Plastic & Reconstructive Surgery

Humberto Palladino, MD, FACS · Answer

I agree with my colleages, if our main concern are the plastysmal bands try the least invasive first to see if is something that works for you. If you want something longer lasting then you can choose a plastysma plasty.

John Fezza, MD · Answer

Vertical banding of the neck is due to a lax platysma muscle. This muscle is tightened with a corset suture to reduce the bands and smooth the neck contour. the surgery can be combined with a facelift if needed.

William Portuese, MD · Answer

The most conservative treatment for platysmal bands is Botox placed in them for a temporizing effect. For a permanent effect, a neck lift procedure with a platysma plasty and transection of the bands over the cricoid area will help improve them.

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