Hello, Dr.! I am a 40 yr old female and nearly 5 months ago I underwent liposuction of the submental area. I was feeling before that the fullness and sagging there was making me look older. I like the new contour, however I now feel that my neck actually looks older because the platysma muscles show whenever I tense my under-chin area or neck even just a little. Even as i swallow it looks all hollowed out. My surgeon suggested either botox or a platysmaplasty. The botox i would judge to become very expensive over a fairly short period. My question then is about what technique to use in platysmaplasty; if you could provide some clarification, theat would be essential. I’ve read about corset platysmaplasty (a la Feldman) in which no muscle is cut. I’ve read that this technique would avoid problems with cutting the platysma in half such as exposure of underlying tissue, making the neck look to thin? I already think my neck is looking old and skinny so I don’t want to make that worse. Additionally I read that cutting the platysma thus would create a greater risk of scarring. My surgeon had talked about cutting the muscle before corseting so…I’m not sure what to do. Do you have a favored approach? Thank you, T. :)
I would have to see and examine you before providing you with specific options related to your neck. However I can tell you that liposuction of the neck can create too much sculpting and exposure of the underlying platysma muscles or even Digastric muscles creating what is known as a “cobra deformity.” If the issue is minor platysma bands with swallowing and movement then trying Botox to see if it treats it is not a bad idea.
Platysmaplasty or submentoplasty is another option. Cutting the platysma at the cervicomental angle is a nice touch but not all patients need that. Not making the cuts can make the neck appear shorter and thicker.
ultimately if the changes you are seeking are subtle you may want to leave things alone because with any surgery scar tissue and asymmetries can occur.