Platysmaplasty is surgery to tighten the subcutaneous muscles of the neck to correct age-related changes.
The neck belongs to those anatomical areas that are among the first to experience the effects of time due to their high sensitivity to external and internal damaging factors (ultraviolet radiation, temperature drop, weathering, metabolic disorders, etc.). It is often the state of the neck skin that can betray a person’s true age, which women are aware of. Furthermore, this area is much more resistant to conservative restorative procedures ‒ nourishing masks and hardware techniques.
Over time, the neck acquires the following signs of aging:
- Flabby skin due to transverse folds.
- Longitudinal grooves due to the separation of the subcutaneous muscle fibres (“turkey neck”).
- An increase in the neck-chin angle, which normally does not exceed 120 degrees.
- The appearance of a double chin.
- Overall “blur” of contours.
Platysma is a thin sheet of muscle located straight under the dermis and tightly inosculated with it. Its fibres are attached to the lower jaw, run to the clavicles and diverge in the form of a fan. Due to this anatomical feature, a neck lift procedure can be performed by excising the relative excess of the muscle, followed by suturing. The skin is smoothed down following the platysma.
Neck lift surgery can solve the following tasks:
- Eliminate longitudinal grooves and subcutaneous muscle fibre damage.
- Eliminate transverse wrinkles and overall skin sagging.
- Reduce the angle between the neck and the chin.
- Correct double chin and excess fat.
- Make contours in the neck more defined.
On the whole, platysmaplasty provides a rejuvenating effect. The surgery is usually combined with improving the shape of the chin (mentoplasty), face lift (for example, SMAS-lifting), local liposuction and other related procedures. Isolated neck correction is much simpler in terms of technical skills and takes less time, but the result will not be very pronounced, since the skin of the face and neck is closely interflowed and has no clear boundaries. In addition, changes in a certain area can break the overall harmony of the appearance due to inadequate skin tension along non-optimal vectors.
There are conditions because of which the planned platysmaplasty can be cancelled:
- Severe pathologies of internal organs (heart, kidney, liver, lungs).
- Oncological diseases.
- Decompensated diabetes.
- Decreased blood clotting.
- Some diseases of the connective tissue (scleroderma, rheumatoid arthritis, etc.).
- Infectious diseases.
- Purulent lesions on the face and neck skin (furunculosis, sycosis).
- Benign lesions in the neck area (atheroma, lipoma, fibroma, large nevi).
- Congenital malformations of the neck.
- Consequences of injury with severe scarring and deformity.
- Mental problems.
Preoperative preparation is common for such interventions. The surgeon examines the patient, ascertains the character of the required changes, collects the anamnesis, detects contraindications and prescribes standardized laboratory and instrumental examinations (tests, fluorography, ECG, blood tests for certain infections, etc.).
Neck lift surgery is performed under general anaesthesia. The incision is made in the area of the chin crease. If necessary, dissections behind the auricles can be also made. Separated platysma fibres are usually sutured along the midline of the neck. Depending on the specific situation, the excess of subcutaneous fat is removed; a resection (partial excision) of the muscle area is performed to make the neck-chin angle defined, etc.
When performing a median (midline) platysmaplasty, or corset platysmaplasty, the surgeon tightens the subcutaneous muscle to the midline. This is the most common surgery technique.
A lateral platysmaplasty, that is tightening the muscles and the skin in outward directions, is usually combined with a face lift (SMAS-lifting, etc.) and is performed through normal access for facelift.
The total duration of the surgery depends on the amount of changes made, additional procedures (liposuction, etc.), the patient’s age and the amount of subcutaneous fat and lasts for about two hours on average. The intervention ends with placing cosmetic skin sutures and a special pressure (shaping) dressing.
For several days, subcutaneous hematomas and oedemas persist in the area of intervention. The stitches are removed in about a week, for another 1-2 weeks the patient must wear an elastic dressing (bandage). Various physiotherapeutic and cosmetic procedures are usually prescribed to accelerate healing (UHF, magnetic therapy, etc.). Physical activity and heat exposure should be limited for about a month. The final result is available in about two months, and it will be persistent (often lifelong).
The most common complications of platysmaplasty are the following:
- Long-lasting oedema and hematoma.
- Skin sensitivity disorder.
- Inflammation and infection of the area of intervention.
- Visible postoperative stitches.
- Symmetry breaking due to uneven skin tension.
- Coarse scarring.
Most problems are solved in a conservative way, in some cases corrective surgery may be required.
Platysmaplasty is a relatively simple and minimally invasive surgical intervention which makes it possible to restore the elasticity, to make the neck contours defined, to rid the patient of the double chin and provide an overall rejuvenating effect.