Loose Neck Skin – Diagnosis and Treatment of Platysmal Bands

A common reason why patients visit my facial plastic surgery clinic in Ottawa is to discuss loose skin under their chin in the neck. Although there are many reasons why this can occur, one reason is due to loosening of a muscle called The Platysma.

The Platysma is a muscle that ‘tenses’ the neck, and is considered a muscle of facial expression. If you tighten the bottom corners of your mouth and tense your neck, you will activate your platysma. The Platysma is a thin muscle that starts under your ear and moves toward the midline of your neck. However, it doesn’t meet in the middle on each side. Because of this, there is an edge to the muscle on each side of your neck.

In image 1a, you can see the edge of the platysma muscle on each side of the patient’s neck. This creates what we call “Platysmal Banding.” It creates the appearance of loose and sagging neck skin.

In image 1b, you can see the changes after a neck lift.

Loosening of the platysma occurs in all people as we age, however, it is apparent in some more than others.

The difficulty with platysma banding is that there are limited options for treatment. In some people, injection with medications like Botox can help, but it is short lived and often doesn’t work as some people would like.

Plastic surgery is the primary treatment of this problem. A neck lift is a common procedure we perform to help get rid of the platysmal bands. This is a surgery that takes about two hours and requires an incision behind the ear and under the chin. In some people, an incision in front of the ear is also required.
Although this surgery is effective, in some people, the bands can come back with time as the tissue continues to loosen.

Image 2 is the appearance of a patient before and after a neck lift, and shows how the bands and loose skin improved one year after surgery.

If you have questions about platysmal banding or loose neck skin, be sure to contact Dr Bonaparte and the plastic surgery team in Ottawa to discuss your options.

Dr Bonaparte, MD, MSc, FRCSC