Facelift Failures: Properly addressing the Neck and Platysma Plication (Neck Bands)
Dr. Koplin discusses his philosophy of aggressively addressing the root causes of an unsatisfactory result in a face lift procedure – the muscular anatomy of the neck; failure to address this vital area will result in a disappointing result in a facelift procedure. Full transcript below.
We see a lot of patients in our office who come in having had plastic surgery, and pretty good plastic surgery of the face, but with failures. And one of the places that they often fail is the neck. So they’ll have a beautiful result above the jawline and they’ll come in and go I still have these bands in my neck, I still have extra loose skin here. It just didn’t get better. I’m unhappy, it didn’t work. So I want to talk a little bit about the anatomy of the neck and why it’s so important to address it in rejuvenation of the face. The face has a muscle in the neck that goes from the jawline to the collarbone. It’s called the Platysma muscle. If you go like this it’s the muscle that jumps up. When we’re young there’s two sides of the muscle and the muscle is stuck tightly together in the middle and as we get older, by chewing, laughing, exercising, and just from time, the two sides of the muscle separate, and the separate slowly to a point where in an old person you can see two very strong vertical up and down bands, and a hollow in between. It is a true hollow. It’s where the muscle has pulled apart and torn apart, and you can see the edges of the muscle through the skin and the hollow in between. Many surgeons don’t believe in addressing that directly, and fixing it, and I’m very much in disagreement with them. What I’m very good at and very comfortable with, and very aggressive at is restoring this anatomy back to the way it was fifteen or twenty years ago, and that often means making a little cut or a little incision under the chin, finding the muscles directly –all the way from the shin down to the collar bone– and very meticulously, in a very anatomic way, putting them back together again with strong and permanent sutures. Then, closing this, finished, and going ahead and doing what other people would consider more of a traditional neck lift. When you restore the anatomy to normal, then you look normal again. You don’t look pulled, you don’t look unnatural, and the only way to have a long lasting, smooth, beautiful result in the neck is to specifically put those structures back. We call it Anterior Platysma Plication. It’s a very important part of neck rejuvenation and I hope this explanation has helped you understand a little bit why I consider it so important and why it’s a very important part of rejuvenation. Thank you very much for listening. I’m Dr. Lawrence Koplin.