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The Neck Lift – A Popular Surgery You Never Think Of

When you think of plastic surgery, a few surgeries may come to mind. Breast augmentations, liposuction, and eyelid surgeries were the three most popular surgeries in North America in 2018. Procedures like nose jobs, face lifts, and tummy tucks may come to mind as well. Have you ever heard of a neck lift or platysmal band removal, though? These two surgeries are in the top 10 most popular surgeries, yet many have never heard of them.

Woman showing the before and after of a neck lift surgery.
Woman showing the before and after of a neck lift surgery.

Neck lifts are commonly included in “full” face lift procedures to create a more natural result. Many patients are happy with the look of their face, though, and only wish to change their neck. Wrinkled, sagging skin, also called a “turkey neck”, is the reason why many seek a neck lift. 


What is a neck lift?


A neck lift is a simple procedure that trims and repositions the skin on the neck. With age, this skin can begin to sag and get a “full” appearance. Similar to a face lift, the procedure can be done with just a few incisions. 

A patient having his neck examined by a surgeon before exploring his options.
A patient having his neck examined by a surgeon before exploring his options.

First, small incisions are made around the bottom of and behind the ears. The soft tissue underneath is then repositioned and trimmed to create the desired appearance. The procedure often includes a small incision under the chin to allow for liposuction. Once the excess fat is removed and the tissue repositioned, the muscles and skin are stitched in place. Any excess skin is trimmed, and the incisions are stitched closed. 


What are platysmal bands?


Playtsmal bands are the bands of excess skin that stretch from the bottom of the neck to the jawline. These bands are caused by the flexing of the underlying platysmal muscle, stretching out the skin. The platysma is a large, plate-like muscle that goes from the top of the torso to the lower jaw. The muscle parts at the top of the neck and runs down to either side of the torso. This muscle serves to open the mouth and control the sides of the lips. The platysmal muscle mainly used when displaying negative emotions, like frowning.

Older woman with platysmal bands along her neck.
Older woman with platysmal bands along her neck.

With time, the playtsma can cause what many know as “turkey neck”, a sign of an aging neck. This happens over time as the edges of the platysma press against the skin. As the skin ages, it loses its natural elasticity. The flexing of the underlying muscle causes the skin to stretch and sag, creating the bands. The platysma itself loses its natural tone and settles in these bands. 


How is removing platysmal bands different from a neck lift?


Both neck lifts and the removal of platysmal bands both give the neck a more youthful appearance. The difference lies in their approach, though. A neck lift concerns repositioning and trimming the soft tissue, muscle, and skin. Removing platysmal bands, also known as a platysmaplasty, mainly involves incisions or stitches in the muscle. Depending on the desired result, there are three approaches a surgeon can take while removing platysmal cords;


  • Lowering the meeting point of the two halves

Platysmal bands appear around the edges of the platysma, near the middle of the neck and at the sides. As stated earlier, this is because of where the edges of the platysma sit. One approach that can be taken is to stitch the two halves together in the middle of the neck. The procedure only stitches a portion of the two halves together so the part in the muscle is lower down. After this, the sides of the muscle are pulled back, creating a slimmer appearance. The skin is then pulled back and excess skin is trimmed.

Demonstration of a platysmaplasty procedure, stitching the muscle together.
Demonstration of a platysmaplasty procedure, stitching the muscle together.
  • Minimally invasive platysmotomy

While a platysmaplasty requires larger incisions, a platysmotomy is a simple procedure that only requires small, needle-sized incisions. Most platysmotomy procedures can be done as an outpatient. This means patients are allowed to leave after the surgery and recover in the comfort of their own home.

The procedure involves the surgeon inserting a hollow needle through the base of the platysmal band, through the skin and sagging muscle. After the needle goes through, a thin metal wire is threaded through. The needle is then fed back through the same entrance and exit holes, but between the muscle and skin. This allows the wire to encircle the edge of the platysma. The surgeon then pulls the wire tight, sometimes using a ‘sawing’ motion to cut through the muscle. This is done at multiple points along each cord. Some surgeons may choose to use a ‘platysmotome’ rather than their hands to control the wire. A platysmotome is a device that simply holds the skin flat while simultaneously pulling the wire through. 

A surgical assistant passing surgical instruments to the surgeon while a surgery is being done.
A surgical assistant passing instruments to a surgeon during a procedure.

While a platysmotomy is much less invasive than a platysmaplasty, it takes longer to see its effects. A platysmotomy works by severing the cord-causing edges of the platysma. The edges lose the ability to flex as they normally would, keeping them from pressing against the skin. With time, the skin will begin to tighten around the neck, reducing the appearance of the cords.


  • Using Botox to remove playtsmal bands

Another effective approach to reducing the appearance of platysmal bands is through the use of Botox injections. Botox is known for its ability to relax muscles and soften the look of wrinkles. Injections into the platysma create an effect similar to a platysmotomy, relaxing the edges of the muscle. This works best in mild cords, but can be used to reduce the look of moderate cords.

A syringe of botox against a pink background
A syringe of botox against a pink background

Which procedure should I get for platysmal cords?


When considering plastic surgery to improve the look of platysmal cords, it is important to consult a plastic surgeon. During a consultation, a plastic surgeon can go over the various procedures for eliminating platysmal cords with you. After understanding your expectations and medical history, the surgeon can recommend the most effective approach. Dr. Tumi has decades of experience in plastic surgery and can provide you with an expert medical opinion. The team at Barrie Plastic Surgery is also proud to offer financing to our patients. We believe everyone deserves to feel comfortable with their body, and affordability should not be an obstacle. Feel free to contact us at any time to set up a consultation.


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