Best neck treatment for skin laxity and/or platysma showing in early 30s? (Photo)

Question

I'm 31 and a year ago started to see 2 vertical lines forming under my chin. When I turn my head to the right, the band going from my chin to my clavicle area sticks out very prominently. Is this loose skin or muscle or both? I have seen one surgeon who suggests a chin implant and to cut or tie my platysma bands at the same time. He said not to do a facelift at this time. I'm looking for confirmation that this course of action will give me the best result or any advice on this issue. Thank you!

Cameron Chesnut, MD, FAAD, FACMS · Answer

Hands-down, no questions asked, before I did anything surgical I would absolutely try putting a neuromodulator like Botox or Dysport in your platysmal bands first. You are young, those bands are caused by hyperactive edges of a muscle, so immobilizing them usually causes them to relax. Your young skin has the laxative to then pull those relaxed bands right back up against your neck. It's a relatively inexpensive option, should be well under $200. If you were my wife/sister/best friend/whatever, this would absolutely be the place I would start. I'm not sure that a platysmaplasty would even be second on my list.

Jed H. Horowitz, MD, FACS · Answer

There are several non-surgical treatments that may help address your concern. Therefore, it would be best to consult with a board-certified surgeon in-person as you may have more than one option. During your consultation, the presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which will determine the options to #rejuvenate your neck. However, chin deficiency with the neck and jawline are also taken into consideration. A weak #chin implies a lack of chin support for the skin along the neck line. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. I suggest consulting with a board-certified plastic surgeon to learn if you a are indeed an #candidate and also more about the #options available and which of those may be best for you.

David Stoker, MD · Answer

I agree that a chin implant is a good option for you now.  It appears that you also have significant laxity of the platysmal bands in the neck.  Normally I would recommend that you wait until you are older to have a neck lift, but it is probably the only procedure that will eliminate the bands in your neck.  A limited platysmaplasty is unlikely to be as effective.

Kenneth Yu, MD · Answer

Hello.  At 31, your'e still very young and doing a neck lift may be overly aggressive at this time.  I don't think a chin implant will dramatically improve those bands.  The bands you see are due to your platysma muscle.  A much simpler option at this stage is to try botox. It's safe and can soften the bands enough to satisfy you.  Take care.

Christopher J. Davidson, MD, FACS · Answer

Thank you very much for your question and your
photograph.To be perfectly honest, at
the age of 31, I would be very hard pressed to recommend a surgical
solution.That being said, a neurotoxin
may very well improve your results/appearance to an acceptable level.I wish you the best of luck!

Raymond E. Lee, MD · Answer

Thanks for sharing. In general current neck rejuvenation treatments include:Surgical Neck lift* with a lower facelift would be the gold standard and gets the best resultsSurgical Neck lift* would be the next best procedureNeck liposuction and/or laser lipolysis if only fat removal is required, typically in a younger patient. A platysmaplasty can be added for further muscle tighteningUltherapy is an FDA approved non invasive tightening using ultrasound technologyKybella is a new FDA approved injection that melts fat under the chinBotox to the platysma bands to decrease their show*It is important the a Neck lift involves some liposuction and importantly a platysmaplasty which is a procedure that tightens the underlying loose neck muscles. I think you  do not think \really need much done.  Botox may be your best options. Talk to several board certified surgeons experienced in face and neck rejuvenation to discuss your options.

Scott K. Thompson, MD · Answer

My recommendation would be for a trial of botox as your neck laxity is fairly minimal at this point.  It would be a good idea to do a formal consultation with an expert however.  Good luck.

Jason Emer, MD · Answer

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, KybellaI treat this everyday in my practice. You may be a surgical candidate but you do not need surgery for improvement. Properly performed liposuction with energy based devices and physical fat removal will do fantastic to remove the fat, lift the skin, and contour the jawline. I pretreat everyone with Botox 1-2 weeks before surgery to relax the neck muscles, allowing for better retraction of the skin after surgery. Then after treatment we do skin tightening with Venus Legacy to improve the results and decrease the neck swelling. I suggest you only see an expert for treatment of this area as a meticulous surgeon is required to get great results and complications in this area can be devastating both medically and cosmetically. A new medication that is used to remove chin fat with injections called Kybella may also be an option, as it secondarily allows for skin tightening/lifting as well. A formal consultation is needed to determine what are the best options for you.  Best, Dr. Emer.

Toby Mayer, MD · Answer

It depends on whether or not you have excess skin or only banding. It appears that you have excess skin which requires a neck lift to remove. The bands can be sutured together at the same time to give a better result.

Reza Momeni, MD, FACS · Answer

In our practice, our approach to this problem is non-surgical.  Botox for the platysma bands to soften them up 2-3 times a year, and Ultherapy to tighten and lift the skin yearly.  This has been very useful in our patients and helps them delay surgery.  You should seek in-person consultation and get the opinion of a well-respected board-certified plastic surgeon in your area.

Best neck treatment for skin laxity and/or platysma showing in early 30s? (Photo)

Answers (15)

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