Aging Neck? Platysmaplasty Will Fix Your Sagging Skin and Neck Bands
The neck often exposes telltale signs of your age well before your face does. These signs can include loss of elasticity, skin laxity, wrinkles, a sagging chin, deep horizontal creases across the neck, or the dreaded turkey wattle neck. While there are various approaches to neck rejuvenation, a cosmetic procedure known as platysmaplasty can address many of these cosmetically displeasing consequences of aging.
Whether you’re a man or woman, aging of your neck generally starts in your 40s, when the gravitational forces of nature combined with physical changes start becoming more apparent. These changes to your neck region subsequently affect your jawline and profile and can drag down your face, making you look much older than you are. Worst of all, neck aging is one thing that good skin care, diet, or exercise regimes simply won’t solve.
We brought in Dr. R. Brannon Claytor, a prominent plastic surgeon based in Bryn Mawr, PA, to discuss a lesser known plastic surgery procedure called ‘platysmaplasty’ — a procedure designed to reverse the appearance of an aging neck and dragging jawline.
How common is neck lift surgery?
It’s important to recognize that there are various types of neck rejuvenation procedures. For instance, if you have minimal aging and good skin condition but still feel uncomfortable with the appearance of your neck, your first approach may be a less invasive procedure such as Kybella or chin liposuction.
However, once signs of neck aging progress and you develop significant skin laxity, a full fledged surgical neck lift or platysmaplasty will likely be your only solution. According to the American Society of Aesthetic Plastic Surgeons (ASAPS), in 2016 there were 29,685 neck lift procedures performed in the United States alone. While the vast majority of these procedures were for women (78.7%), increasingly men are seeking more contoured necks and defined jawlines as well.
Neck rejuvenation isn’t something necessary in your younger years, so it’s not surprising that the largest age group seeking neck lifts are those between 51-64 years, followed by people over 65 who have a growing interest in all types of plastic surgery procedures that can help them maintain a more youthful appearance.
What is platysmaplasty surgery?
On each side of the neck there is a broad, thin layer of muscle that rises from under your collarbone and makes it’s way up to the base of your chin and jaw on each side — it’s called the platysma muscle. The platysma muscle is divided into two distinct sides that meet in the center of the neck.
“Platysmaplasty is performed when a patient’s central neck platysma muscle is significantly diastatic, meaning when it is significantly pulled apart in the midline, revealing deep neck bands,” says Dr. Claytor.
This deep banding around the neck is called platysmal banding. Unfortunately, as you age the connective tissues underlying the skin become weak and begin to lose elasticity, it just occurs to different extents in different people. Aside from banding, the result can be an unsightly double chin, a cord-like look around the neck, fatty jowls that hang down into the neck and chin area, and that unsightly turkey wattle we’ve already mentioned.
A platysmaplasty surgery, also commonly known as ‘corset platysmaplasty,’ is a type of neck lift surgery that addresses these muscles, specifically tightening and reconstructing the platysma muscle to repair the loose sagging or banding skin on the neck. The procedure rejuvenates the neck, restoring it to a more aesthetically pleasing shape and contour.
How is a platysmaplasty different from a regular neck lift?
It’s not uncommon for the platysma muscle to be manipulated during a lower rhytidectomy or ‘regular neck lift.’ But the way it’s done is often different.
“With a regular neck lift the platysma is often stretched laterally (sideways) and superiorly (upwards) to retrieve the tissue. A platysmaplasty neck lift procedure is where the muscles are pulled centrally to tighten them,” says Dr. Claytor. The platysmaplasty procedure addresses issues where the platysma muscle is at it’s weakest, which is under the chin.
To picture what a platysma procedure does, imagine how a corset pulls in the waist to form a more shapely figure. A similar type of process is used to ‘corset’ the platysma muscle to form a more shapely contour. When the two sides of the platysma muscle are brought together, it creates a singular sheet of muscle that is taut, smooth, and no longer has the ability to droop or form unsightly neck bands.
How is platysmaplasty performed?
“There are multiple techniques for addressing issues with the platysma muscle, but the most common surgical procedure is an open platysmaplasty,” informs Dr. Claytor. “Under a general anesthesia, the neck is opened with an incision underneath the chin (submental incision) where direct removal of excess fat is performed with electrocautery or dissecting scissors. Once the platysma muscle is exposed it is brought back together with corset platysmaplasty sutures.” These sutures literally resemble a corset, with multiple rows of surgical stitching that pull together and secure the platysma muscle centrally. The procedure takes approximately two to three hours.
“While the corset platysmaplasty is the most common, there are multiple variations of platysmaplasty that may be used to address specific patient needs,” explains Dr. Claytor. “For instance, another type of platysmaplasty procedure involves cutting away a wedge of platysma muscle to allow less animation of the neck, subsequently leaving fewer lines and wrinkles.”
Although the platysmaplasty procedure can be done as a stand-alone procedure, it is often performed in conjunction with liposuction, a facelift, or cheek lift. And as Dr. Claytor mentioned above, the platysma muscle is usually manipulated with a regular neck lift, only it may occur in a different manner.
As with any procedure you might be considering, your surgeon will sit down with you in advance to discuss your goals and assess your individual needs. From there, he or she will advise what they feel are the best procedures to address your specific problem areas.
How long is recovery time after platysmaplasty?
Dr. Claytor informs that after platysmaplasty surgery, most patients will require drainage for the first night. Your surgeon will provide you with detailed post-surgical instructions to help you manage drainage and get the best recovery.
As for your recovery timeline, a platysmaplasty is similar to a facelift or regular neck lift, often involving swelling and bruising for upwards of one week. By their second week post-surgery most patients feel well enough to resume their regular activities and will often go back to work — although some prefer to wait until the third week.
Your surgeon will likely advise you against engaging in more strenuous activities for a period of four to six weeks.
What are the common complications of platysmaplasty surgery?
Fortunately, serious complications arising from neck lift procedures are very rare. According to Dr. Claytor, complications resulting from a platysmaplasty could include persistent animation (movement), contour deformities, and in some cases, hematoma (a solid swelling of clotted blood within the tissues that appears as a type of bruising).
Occasionally persistent animation and contour deformities can be corrected with revision surgery or subsequent procedures.
There is, however, one thing you should be prepared for: expect to feel a tight sensation around the neck at first, which can be very uncomfortable. Rest assured that in time this sensation will dissipate, but it could take up to several months before it disappears entirely.
Will I have a scar from platysmaplasty surgery?
“Platysmaplasty does require an open excision of tissue and surgical repair, therefore patients can expect some scarring,” informs Dr. Claytor. “The procedure generally requires a relatively small incision that may be upwards of one inch long. Except it’s made underneath the chin to help conceal the scarring.”
How long does a platysmaplasty procedure last?
As for your neck rejuvenation results, they will be visible immediately after your platysmaplasty procedure and continue to improve over the first one to three months following surgery.
The best news though, is that under most circumstances the results of neck lift surgery are long-lasting. The need — or desire — to get another neck lift will largely depend on your age. After 10 or 15 years it’s not uncommon to see some recurrence of platysmal bands or jowling, which is something you may choose to address at the that time.
Meanwhile you can take comfort in the knowledge that the vast majority of people only require a neck lift once in their lifetime.
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