What to Know Before You Have Platysmaplasty Surgery

If the eyes are the first place we show our age, then the neck is arguably the second. As we get older, vertical banding and horizontal creases may appear in the skin of the neck. If you so desire, these creases and banding can be corrected with plastic surgery through a procedure called platysmaplasty.

This article will review exactly what a platysmaplasty is, why it's done, and what to expect before, during, and after surgery.

Doctor examining female patient's neck
Jose Luis Pelaez Inc / Getty Images

What Is a Platysmaplasty?

A platysmaplasty is named for the platysma muscles which run along the front of the neck. The surgery tightens the skin and underlying muscles to lift the neck. It also improves and sharpens the contour of the jawline.

A platysmaplasty is technically a separate procedure from a neck lift, but platysmaplasty and neck lifts are often performed in conjunction with a facelift. Platysmaplasty may also be a stand-alone procedure.

Complementary Procedures

Platysmaplasty is often done in conjunction with other surgeries to enhance the patient’s results. These procedures can include:

  • A facelift to correct sagging of the mid and lower face.
  • A chin implant to improve the neckline and enhance a receding chin.
  • A rhinoplasty which reshapes the nose to balance facial proportions.

Additionally, skin resurfacing procedures (e.g., laser resurfacing or chemical peels) to improve the overall look and feel of the skin are effective enhancements that do not involve surgery.

Results may also be enhanced through the use of Botox injections or non-surgical skin tightening using lasers or radio-frequency technology.

Who Is a Good Candidate?

The best candidates for a platysmaplasty are non-smokers who are in generally good health and who have a positive outlook and realistic expectations about the outcome. Sagging of the neck may be due to age, but may also be a result of significant weight loss or heredity.

Those who have sagging and/or wrinkling of the neck and a loss of separation between the neck and the chin or jaw can benefit from a neck lift procedure.

What to Expect on the Day of Surgery

Before Surgery

Your surgeon will likely order preoperative lab tests to confirm your health status. They may also require that you adjust, cease, or begin taking certain medications a week or two before your surgery.

You should avoid aspirin, many anti-inflammatory drugs, and herbal supplements in the two weeks before surgery. All of these can increase bleeding. Talk to your surgeon about everything you may be taking.

During the Surgery

Anesthesia is administered. Neck lift surgery can be performed either under IV sedation or general anesthesia. For a minimal lift, your surgeon may even determine that regional anesthesia or a combination of an oral sedative and local anesthetic link may be sufficient.

Incisions are made. The traditional neck lift incision begins in front of the earlobe and loops under and behind the ear ending in the scalp towards the back of the neck. If the platysma muscles are tightened, there may be an additional small incision under the chin. However, more specialized procedures may involve an incision only inside the hairline at the back of the neck (known as a posterior neck lift), or behind the ear only (for some suspension techniques). This depends on the techniques used and the degree of lifting required.

Platysma muscles are tightened. In an aging face, the platysma muscles often separate. This creates a loss of support for the skin and a tendency toward a vertical “banded” appearance of the neck. Using sutures, these muscles are sewn back together in the center with a technique similar to lacing up a corset. It is also possible that a small piece of this muscle will be removed or that some laser-assisted tightening is used on the underside of the deeper layers of the skin.

Excess skin is removed. Excess skin is carefully trimmed away.

Tissue and skin are repositioned and secured. In the case of a suspension lift, the surgeon will use some sort of sutures, mesh, or other materials in the deeper layers of the skin and muscles. This creates a “hammock” to suspend and hold the tissues in their new, higher position.

Incisions are closed and bandaged. The surgeon closes the incisions using dissolving sutures or ones that will need removal. If needed, drains will be placed at this time before bandaging the wounds.

After the Surgery

Most neck lifts are performed on an out-patient basis. After surgery, your surgeon will place a pressure dressing that will wrap around your head and underneath your chin.

Your neck will feel tight and sore as the anesthesia wears off. It may show even more swelling and possible bruising over the next three days. Dressings may be removed when instructed by your surgeon, but any sutures will remain in place for seven to 10 days.

Recovery

Most patients can return to non-strenuous work after five to 10 days. However, for the first few weeks after surgery, you should avoid bending over and lifting heavy objects. You will also have to sleep with your head elevated for one or two weeks.

These guidelines vary widely based on your health, techniques, and other variables. Always follow your surgeon’s recommendations.

Risks and Complications

Risks and possible complications include excessive bleeding or hematoma, skin loss (tissue death), blood clots, and persistent edema (swelling). There is also the possibility of skin contour irregularities, discoloration and swelling, and unfavorable scarring. You may experience numbness or other changes in sensation or intense itching.

As with all surgical procedures, there are risks associated with anesthesia. Additionally, the effects of plastic surgery may not be exactly what you thought, and unsatisfactory aesthetic results are a reality. In some cases, there may be a need for additional surgery as well.

After surgery, call your surgeon immediately if any of the following occur: chest pain, shortness of breath, unusual heartbeats, or excessive bleeding.

Summary

A platysmaplasty is a type of cosmetic surgery used to tighten the skin and muscles in the neck and remove excess, sagging skin. It may also be used with other surgical procedures, such as liposuction or a facelift.

The surgery is done by a plastic surgeon, who will provide specific instructions to be followed before and after surgery.

A Word From Verywell

A platysmaplasty can be a safe and well tolerated procedure used to lift the neck and improve appearance of sagging skin. It should be done by a plastic surgeon who is skilled in this type of procedure. Be sure to follow all of the instruction provided by the surgeon, so you can get the best outcome possible.

Frequently Asked Questions

  • What is the difference between a neck lift and a platysmaplasty?

    A neck lift and platysmaplasty are different names for the same surgery. It is done to remove excess fat and skin from the neck.

  • Does a platysmaplasty hurt?

    A platysmaplasty is a surgery, and pain can be a side effect of the surgery. The surgery is typically done with anesthesia, and you will not be awake enough during the surgery to feel pain. Pain medications can be given postoperatively to be as comfortable as possible.

  • How long does it take to recover from a platysmaplasty?

    It can take a few weeks to fully recover from the surgery. Following the directions provided by the surgeon can help you recover safely and successfully.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Medicine. Neck lift.

  2. American Board of Cosmetic Surgery. Neck contouring guide.

  3. American Society for Dermatologic Surgery. Neck lift.

  4. Pérez P, Hohman MH. Neck Rejuvenation. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021. PMID: 32965900.

  5. American Society of Plastic Surgeons. Neck lift: How should I prepare for neck lift surgery?

  6. American Society of Plastic Surgeons. Neck lift: What are the steps of a neck lift procedure?

  7. Mahmoud N, MAssoud K. Ipsilateral lateral suture suspension platysmaplasty: A modified less invasive technique in neck. The Egyptian Journal of Plastic and Reconstructive Surgery. 2020;43(3):389-393. doi:10.21608/ejprs.2020.68167

  8. Kang MS, Kim SH, Nam SM, Park ES. Evaluation of elastic lift for neck rejuvenation. 2016;22(2):68-73. doi:10.14730/aaps.2016.22.2.68

  9. American Society of Plastic Surgeons. Neck lift: What are the risks of neck lift surgery?

  10. American Society of Anesthesiologists. Effects of anesthesia.

Additional Reading
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By Julie Scott, MSN, ANP-BC, AOCNP
Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community.