The deep plane neck lift (or platysmaplasty) is really a group of procedures which aim to address a number of features of ageing seen in the neck and jawline. As in the face, these encompass several anatomic sites, all with different effects:
- Excess/ malpositioned submental fat. This creates a heavy, poorly-defined neck contour and contributes to the appearance of loose skin/ soft tissue under the chin.
- Skin laxity. Appears as either vertical or horizontal creases and contributes to a poorly-defined neck.
- Platysmal bands. These are the vertical bands seen at the front of the neck, and can be at rest (due to laxity) or hyperactive. These can be hard to treat in some cases.
- Platysmal laxity. The laxity of platysma muscle contributes to a lax, poorly-defined neck and jawline.
- Other areas can contribute to the shape of the ageing neck including submandibular glands that have descended or enlarged digastric muscle.
- The concept of the deep plane neck lift technique describes how I not only lift and reposition the skin, but importantly, address the effects of ageing on the platysma muscle and deep ligamentous structures by operating beneath the platysma and releasing it as needed.
What can I expect?
A neck lift (platysmaplasty) is a powerful technique to address many of the signs of ageing in the neck and jawline. The neck lift aims to achieve:
- A sharper jawline and angle between jaw and neck.
- Reduction of any ‘double chin’ contour.
- More contoured neck shape.
- Smooth out any prominent muscle bands.
Most often a neck lift is combined with a lower facelift to ensure harmony between the two areas.
What happens before surgery?
The day of your procedure, you will arrive as planned to the hospital where all the staff will be expecting you. They will check your details and ensure all the preliminary paperwork has been done (there’s lots of this, but it’s really important). Before your procedure, your Anaesthetic Specialist will discuss your anaesthetic plan, including any pain medications you may need during your post-operative recovery phase. I will meet you again to make sure everything is taken care of, before drawing my surgical markings and any additional photographs as necessary.
What happens during surgery?
You will be under general anaesthesia, with state-of-the-art monitoring and safety protocols. There will be an incision along the ear crease or just behind the tragus, then sweeping around the back of the ear and sometimes along the hairline behind the ear. In most cases, there will be another incision along the crease line behind your chin. Depending on your body and personalised requirements, neck lift (platysmaplasty) surgery may be performed incorporating many techniques:
- Submental (top of the neck, under the chin) liposuction of preplatysmal fat. This helps define the anterior neck and angle between neck and jawline.
- Subplatysmal fat excision. This technique helps to define the upper neck.
- Anterior platysmaplasty. This can reduce some visible platysmal bands and refine the neck contour.
- Lateral platysmapexy. This highlights and strengthens the lateral jawline and angle of the jaw whilst reducing laxity.
Once the neck lift has been performed, surgical drains may be placed, or alternatively, a ‘surgical net’ technique may be used to help redrape the layers of tissue.
What happens after surgery?
Most patients stay overnight in the hospital before going home the following day. We will review you closely over the coming days and weeks, depending on your individual treatment plan. Any drains are usually removed after a day or so. In conjunction with your Anaesthetist, you may be provided with some strong pain relief if required.
While Richard and his team do everything possible to help you achieve the best outcome, there are some things that you can do to be an active participant in your recovery.
- Firstly, read and follow you’re the instructions we give you around surgery.
- Secondly, do not smoke or vape at all and avoid nicotine patches. This can easily cause wound problems ranging from delayed healing to suture line breakdown, and at worst, widespread skin death.
Possible complications
The decision to undergo neck lift surgery is a very personal one, and should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of neck lift surgery include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Blood loss requiring transfusion or urgent return to the operating theatre.
- Surgical site infection.
- Wound breakdown, delayed healing or protruding sutures.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Loss of hair growth around scars.
- Numbness (temporary or permanent).
- Persistent or recurrent platysmal bands
- Prominent or accentuated submandibular glands/ digastric muscle
- Facial nerve injury (temporary or permanent facial weakness, including paralysis).
- Fluid accumulation or leak which may require drainage.
- Fat necrosis (some fat deep in the surgical field might die, leaving lumpy or irregular contours).
- Asymmetry, areas of tightness, pleating or contour irregularities.
- Possible need for revisional surgery.
- You should understand that other people will probably notice you have had facial surgery, and this may draw attention.