Platysmaplasty Neck Lift: Indications, Types & Best Technique

Platysmaplasty is one of the most technically difficult operations performed by many plastic surgeons, but with very different results.

Indications for Platysmaplasty

The direct indications for platysmaplasty ^pubmed are:

• looseness of the skin of the neck;
• double chin;
• “bands” running from the chin downward (“turkey bands”);
• loss of a beautiful cervico-mental angle.

There are three ways to perform this operation; let us consider each in more detail.

Methods of Performing Platysmaplasty

1. Lateral Platysmaplasty

In lateral platysmaplasty, the plastic surgeon horizontally stitches together the diverged edges of the platysma and tightens the muscle tissue. When performing the operation by this technique, the incision is made in the submental crease.

Most often, plastic surgeons choose precisely this method of platysmaplasty because, while guaranteeing a more or less visible result, technically it is not a very complicated procedure and is usually a component of a facelift (SMAS).

As a result of performing lateral platysmaplasty, the excess skin disappears, as do the so-called “bands” in the upper part of the neck. However, the platysma extends beyond the area accessible through this technique, which many patients simply do not realize. Therefore, the bands – the very reason why most patients decide on this surgery – will partially remain.

It is impossible to achieve a 90-degree cervico-mental angle using this method.

2. Medial Platysmaplasty

In medial platysmaplasty, the plastic surgeon pulls the muscle tissue toward the center of the front part of the neck. By making an incision directly under the chin, the surgeon gains access to the subcutaneous and muscle tissues, after which the platysma is tightened and stitched together.

When performing medial platysmaplasty, it is also impossible to achieve an ideal cervico-mental angle, because the work is done only in the submental area (the region of the digastric muscles), without extending to the lateral surfaces of the neck.

3. Combined Platysmaplasty

This is technically the most complex method, in which both lateral and medial platysmaplasty are performed simultaneously, making it possible to achieve the ideal 90-degree cervico-mental angle.

For the past six years, this method has been performed on all patients without exception, consistently delivering results that can satisfy even the most demanding expectations. From a professional standpoint, half-measures are not acceptable in such cases: if there is an opportunity to achieve an almost perfect neck in older patients, it should certainly be utilized.

The combined type of platysmaplasty includes:

• an incision in the submental crease (up to 2 centimeters);
• removal of fatty tissue, i.e., liposuction (the amount depends on the volume of subcutaneous fat in the chin and jowls area);
• dissection of the platysma down to the level of the hyoid bone along the midline (under endoscopic control);
• horizontal dissection of the platysma in both directions up to the mandible;
• removal of retroplatysmal fat;
• thinning of the anterior portions of the digastric muscles of the neck (which add extra volume to the submental area) and tightening of their posterior portions;
• stitching the previously dissected platysma in the form of two triangles, which allows the formation of the ideal cervico-mental angle.

After that, since excess skin in the chin area still remains, surgeon performs a SMAS facelift, during which also carries out lateral platysmaplasty, removing the remaining redundant skin and tightening tissues in the lateral directions as well. Once this stage is completed, the final result of the operation can be seen.