Information about the procedure
Restoring a defined line between the chin and neck by correcting the platysma and removing the excess.
On this page
What it involves
The platysma is a thin layer of muscle covering the front of the neck. With age, its two edges separate in the midline and become lax. This produces platysmal bands — the vertical cords that stand out on the front of the neck, especially when speaking or turning the head. The same laxity also blurs the angle between the chin and neck.
Platysmaplasty brings these edges together along the midline and restores the supporting layer. Where necessary, fat above and below the muscle is also removed.
The neck is the area that most often gives away a person’s age, even when the face looks good. Correcting it therefore often has a greater visible effect than the patient expects.
Types and approaches
Isolated platysmaplasty
The two edges of the muscle are brought together through a small incision under the chin. Suitable when skin elasticity is good and there are prominent platysmal bands without significant excess skin.
With liposuction of the submental area (under the chin)
This combination is very common — the fat is removed first, then the muscle is corrected.
With a facelift
Where there is marked excess skin, surgery on the neck alone is not enough. The excess skin is removed through incisions around the ears.
Submental liposuction alone
For young patients with good elasticity and localised fat, without a muscle problem.
Who it is suitable for
Suitable for
- Vertical platysmal bands on the front of the neck
- Loss of a defined angle between the chin and neck
- Fat accumulation under the chin
- Good skin elasticity, if the neck is treated on its own
- A realistic understanding of when a facelift is also needed
Not suitable, or postponed, in cases of
- Marked excess skin — platysmaplasty on its own gives an incomplete result
- Significant excess weight
- Current smoking
- Uncontrolled high blood pressure
- Untreated thyroid disease with a goitre
Preparation
- Consultation with separate assessment of the fat, muscle and skin elasticity
- Assessment of chin position — with a small chin, the result is more limited
- Stopping smoking
- Pre-operative tests and a consultation with a cardiologist or an anaesthetist
- A neck compression garment ready for after surgery
How it is performed
The operation is performed under general anaesthesia or local anaesthesia with sedation and usually takes two to three hours.
The incision is small and placed in the natural crease under the chin, where the scar remains virtually invisible.
After the procedure, a neck compression garment is applied; it is worn day and night for the first few days and then at night only.
Recovery
- The first 48 hoursSwelling and a feeling of tightness when swallowing and turning the head. The compression garment is worn day and night.
- The first weekSwelling peaks. The stitches are removed around day 7. Bruising on the neck and under the chin.
- 2–4 weeksReturn to work is usually possible after 10–14 days. Firm areas under the skin are normal and gradually soften.
- 1–3 monthsThe contour is clearly visible. Numbness in the submental area gradually resolves.
- 6 monthsFinal result.
Pain and discomfort
The discomfort is moderate. The main sensation is tightness when swallowing and moving the head, which subsides within about a week. Standard painkillers are usually sufficient.
Risks and complications
Every intervention carries risks. Listing them does not mean they are expected to occur — it allows you to make an informed decision.
- Haematoma under the skin of the neck — requires urgent evacuation
- Contour irregularities or visible ridges after liposuction
- Recurrence of platysmal bands over time
- Temporary weakness of a branch of the facial nerve, causing an asymmetric smile
- Changes in sensation in the neck skin
- Visible hollowing if fat is removed too aggressively
- Unsatisfactory result if excess skin was underestimated
Results and longevity
The result lasts for years, but the neck continues to age. When skin elasticity is good to begin with, the effect lasts longer.
Patients with a small or receding chin get a more limited result — for them, combining the procedure with mentoplasty considerably improves the final appearance.
If excess skin has been underestimated, the result looks good lying down but unsatisfactory when upright. This is why the assessment at the consultation is done with the patient sitting.