Is the corset platysma muscle surgery the only way to fix a neck lift?

Correction of the laxity of the neck muscle ( platysmaplasty) could be performed in multiple forms. When the muscle is tightened in the center of the neck that is called corset platysmaplasty ( medial platysmaplasty)Then the muscle is tightened only from the sides of the neck. that is called medial platysmaplasty.Generally, small neck laxity could be corrected with either corset or lateral plastysmaplasty. When the neck is very lax, usually both the medial and the lateral plastysmaplasty may be performed.Therefore, the type of platysmaplasty to be performed on a patient depends on the neck physical findings.  

The neck is the most common concern for the majority of my patients.  There are multiple less invasive treatments to treat other parts of the face, however excess skin of the neck or prominent platysma muscles are difficult to treat without surgery.
The discussion of having a corset platysmaplasty or not is an argument that plastic surgeons have all the time at our yearly meeting.  I personally, typically tighten the muscles in the neck and free up the entire neck when I do a face and neck lift.  I believe that the neck is extremely important in helping patient achieve the look they desire from a facelift.  Tightening the muscles in the neck allows me to give patients more of a right angle appearance to their neck.  It also prevents the appearance of the edge of the muscles over time.  With the muscles sutured together it is unlikely that muscles will fall and be visible again after the surgery. 

There are ways to perform a neck lift without tightening the muscles and suturing them together, however this is rare my personal practice. 

Please discuss your face and neck lift surgery with a board-certified plastic surgeon that performs a high volume of face and neck lifts.  Your surgeon will be able to discuss the entire procedure with you and why they do things the way that they do.  Also look at before and after pictures.  If you like the appearance of their pictures then you are likely to be happy with the results of your facelift as well.  

Hello,Many patients considering neck lift surgery ask this very question.  The short answer is yes: the platysma muscle must be tightened to create a beautiful contour that lasts many years. A 'skin only' lift may look good for a few months but inevitably the neck tissues stretch and sag. I see many patients for corrective work who have this exact complaint following a 'skin-only' neck lift.  When there's not much sagging skin, my preferred technique is a minimal incision approach (I call this a 'closed neck lift'): I make 3 short (~1.5 inch) hidden incisions, 1 behind each ear and 1 under the chin.  Following liposuction, I separate skin from underlying platysma muscle, and then I suspend the platysma muscle with multiple permanent sutures anchored to the very strong tissue behind the ear (called the 'mastoid fascia').  Sometimes tightening of the muscle in the midline (a 'corset platysmaplasty') is needed to prevent central sagging. Scars are virtually invisible, the neck contour is lifted and contoured, and the results last for many years.  Recovery is about a week and my patients have been very satisfied with this approach. All my best in your search!Dr. Rad

You may not need a platysmaplasty and in certain cases, it is not necessary. But this needs to be decided before surgery, because platysmaplasty often needs to be done in conjunction with a lift. Seek another personal evaluation if you are not satisfied.

Thank you for the question. The answer is yes. A one size fits all approach does not apply facial rejuvenation of the neck and face. There are several ways to address the central neck (submentum) during rejuvenation depending on your needs. In many patients with early aging changes, a limited sideways/ lateral elevation and resuspension of the platysma is adequate. For patients, with excess skin laxity and heavy necks, this can be inadequate and usually lead to early failure. The weight of the tissue causes relaxation and the muscles again splay and or the face to have a windswept look. However, if an extended SMAS (the strength layer under the skin) or deep plane dissection is utilized to allow adequate movement of SMAS/skin flap in a true vertical manner then this can sometimes eliminate then need for a corsette platysmaplasty. This is not the same as removing a little SMAS and closing the edges together or just placing sutures to tighten the SMAS. Managing the central neck directly allows both the muscle edges and selective fat to be removed under the platysma prior to creating a stable corsette to sharpen the neckline and decrease the chance the muscles will splay.  Ultimately, a corsette platysmaplasty in combination with an extended SMAS correction can give a reliable, long lasting result even in the toughest necks when other techniques tend to fail.  I hope this helps and your surgery goes well.  Take care.

Your doctor is right. The neck is a part of the face and should be treated with the face. If the neck is treated by itself, you will still have facial problems that are not addressed. When the facelift is done correctly, greater than 90% of necks can be corrected completely posteriorly without accessing the platysma centrally. Only when you have a significant central platysma band that does not resolve with lateral superior pull of the muscle do you need to sew the platysma together centrally and divide the muscle at the level of the hyoid. This can almost always be determined preoperatively.

 Hi, I have performed many facelifts and neck lifts over the past 30 years.  There are numerous ways to remove skin and improve the appearance of the neck, including platysmaplasty using the corset technique.  Non smiling photos of your face from the front and side would help in the evaluation and identify which ones would benefit you the most.
Hope this helps.

Hello and thank you for your excellent question. The best answer is that you need to be evaluated in person. There are many different neck lift techniques, of which the corset platysmaplasty is one of them. It is not the only technique, but it is still one of the more effective techniques for neck lift. However, not all patients need it. This decision should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 


Best,
Jon Ver Halen, MD FACS 

Harvard educated plastic surgeon