Why Neck Bands can Recur after a Neck Lift, and its Minimally Invasive to Full Surgical Treatments

Author: Amiya Prasad, M.D.

Thank you for your question. You submitted several photos and you provide in your question a history where you underwent a neck lift procedure as well as some body procedures but specifically a necklift with incisions behind the ear and under the chin 3 months prior. And you’ve noticed a band forming that your surgeon from Mexico acknowledges. And you are asking what you can do as opposed to going back to Mexico to have a revision surgery done. And again, this is 3 months later. Well, I can certainly share with you my knowledge and experience when it comes to this type of issue.

A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Face lifting and neck lifting has been a very significant part of my practice for many years. And certainly, as time has transpired and evolution of different devices and techniques and injectables have come along, I have adjusted and modified accordingly to try and help my patients in the predictable and practical way when it comes to this type of desire to improve the neck area. So, to begin with, when we talk about the neck procedure, I would suspect that if you had a band like this before the surgery that the incision under your chin was used by your doctor to do a procedure called a platysmaplasty. And that’s a procedure where the edges of the platysma muscle which appear to be separated are sutured together and brought together to create a nice neck angle. And then the neck lifting procedure, the platysma from the back is tightened so you get a nice sharp angle. One of the challenges of neck lifting procedures and this neck banding that occurs is the possibility of recurrence.

And not a single surgeon who does this type of surgery would not honestly acknowledge that recurrences happen more frequently than they would like or they would ever predict. And the reason is that as surgeons, we are essentially trained to repair and we do that. We find the edges of the muscle and meticulously suture them together and do everything in the right way and we watch our colleagues who demonstrate these procedures in live surgery events and meetings, etc. But a lot of times, these bands occur. One of the reasons I feel is that the muscle itself is very thin. So even when the sutures are placed, the muscles can separate and you can get a detachment.

Or the muscle can just end up relaxing in a way that results in a recurrence of the band. There are a lot of reasons for that to occur. Now when you’ve already had the skin elevated and you’re down to this platysmal band which is again the platysma muscle, you can consider options to try that are less invasive first. You can start with a neurotoxin like Botox®. Botox® can relax this muscle and help improve the appearance of the band. If you want to get a little bit more aggressive, there is a technique called suture suspension where the muscle and the tissue surrounding it is elevated through little openings made in the skin.

Why Neck Bands can Recur after a Neck Lift, and its Minimally Invasive to Full Surgical Treatments

It’s not a thread lift but it’s a similar idea where the platysma is elevated and sutured behind the ear in a strategic way to see if that can help with that appearance. And of course, you could try and undergo a revision surgery where the platysma is opened, the platysmal band can be cut, it can be re-sutured etc. So you can have a revisional surgery done to try to address that band specifically. There are pros and cons to all these techniques but I think my suggestion of doing something in a minimally invasive to more invasive approach might be easier logistically for you. This is a challenge and unfortunately, it’s one of the realities of this type of surgery. And so, I think that you can visit local cosmetic surgeons who perform this type of surgery to get an informed opinion.

Certainly, examination will help where you can make some movement and actions and see how that muscle responds. And then you can decide what you would like to do. But I think that sometimes people will suggest like a thermal energy device and I would dissuade you. I don’t think a thermal energy device would end up shrinking the skin in the neck well enough to push back a muscular band. I think that probably the closest to getting to where you want without surgery would be something like Botox® and that can be done with some consistency. So I hope that was helpful, I wish you the best of luck and thank you for your question.

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