On this page
What is platysmaplasty? | What it treats | Compared with other neck procedures | How it is performed | When a deep neck lift is needed | As part of a facelift | Choosing a surgeon | Who may be suitable | Recovery | How long results last | Risks and complications | Cost in Sydney | Before and after photos
What Is Platysmaplasty?
Platysmaplasty is a repair of the platysma muscle. The platysma is a broad, thin muscle that runs from the collarbone over the front of the neck and into the lower face, where it is continuous with the SMAS. With age, its inner edges can separate in the midline, and the vertical cords many people notice on the front of the neck are those edges. They are not a separate muscle developing.
In a platysmaplasty, the separated edges are brought together and sutured in the midline through a small incision under the chin, and fat above the muscle is removed where present. This is the standard neck lift, sometimes called the traditional neck lift. It repairs the muscle rather than tightening the skin alone.
Dr Turner performs platysmaplasty as part of a facelift. Every deep plane facelift includes a lateral neck lift, which suspends the platysma at the side of the neck, and adding a platysmaplasty at the front of the neck makes it a lower facelift. Without a facelift, central platysmal bands are treated through a direct neck lift.
What Platysmaplasty Treats
Platysmaplasty may be considered where the changes sit in the layers the operation reaches:
- Vertical platysmal bands on the front of the neck.
- Fullness under the chin where the fat sits above the platysma.
- Loss of definition of the cervicomental angle, the angle between the chin and neck.
- Loose neck skin, which is redraped through the facelift incisions.
It does not treat:
- Fullness from fat beneath the platysma (subplatysmal fat).
- Prominent submandibular glands or bulky anterior digastric muscles.
- A chin that sits back, which a chin implant may change.
Where the structures beneath the platysma contribute, a deep neck lift is used instead of the standard neck lift. The jowls and lower face are treated by the facelift itself.
Platysmaplasty Compared With Other Neck Procedures
“Neck lift” is an umbrella term, and the operations under it are often confused. In short, platysmaplasty repairs the platysma at the front of the neck, while a deep neck lift also works on the structures beneath it. In Dr Turner’s practice they relate as follows:
| Procedure | What it treats | How it is performed |
|---|---|---|
| Lateral neck lift | The platysma at the side of the neck | Part of every deep plane facelift |
| Standard neck lift (this page) | Bands and fullness at the front of the neck | Added to a deep plane facelift, making it a lower facelift |
| Deep neck lift | Fat, muscle and salivary glands beneath the platysma | On its own, or with a deep plane facelift |
| Direct neck lift | Central bands, fat and loose skin where the lower face is stable | On its own, through an incision under the chin, with a vertical Z-plasty incision where skin is removed and, in some patients, incisions around the earlobe and behind the ear |
The neck lift page compares every option, including neck liposuction and chin implants, and when each may be considered.
How Platysmaplasty Is Performed
Platysmaplasty is performed under general anaesthesia at an accredited Sydney private hospital, usually as part of a lower facelift. A standard neck lift adds about 30 minutes to the deep plane facelift, so a lower facelift takes about 4 hours 30 minutes in theatre, followed by an overnight stay.
- Incisions. A small incision in the crease under the chin gives access to the front of the neck. The facelift incision runs in front of and behind the ear and along the temporal and occipital hairlines, and loose neck skin is redraped through it.
- Fat. Fat above the platysma is removed where present, by direct excision or limited liposuction, before the muscle is repaired.
- Muscle repair. The separated edges of the platysma are sutured together in the midline (medial platysmaplasty). Where banding is heavier, a running suture along the midline (corset platysmaplasty) may be used. At the side of the neck, the platysma is suspended as part of the facelift (lateral platysmaplasty, or lateral neck lift).
- Skin. The skin of the face and neck is redraped through the facelift incisions, and the incisions are closed in layers.
The combination of techniques is chosen at surgery, based on the pattern of separation and the underlying anatomy. Theatre times shown are for women; surgery for men is scheduled with an additional 30 minutes.
When a Deep Neck Lift Is Needed Instead
A platysmaplasty can repair the muscle as planned and still leave the neck looking full if the cause sits deeper. Fullness that persists after a platysmaplasty often comes from subplatysmal fat, prominent submandibular glands or bulky anterior digastric muscles, none of which a standard neck lift reaches.
Where these structures contribute, a deep neck lift is used instead of the standard neck lift. With a facelift, it adds about an hour of theatre time rather than 30 minutes. The question at consultation is which layer is driving the change, and whether the planned operation reaches it.
Platysmaplasty as Part of a Facelift
Because the lower face and neck usually age together, platysmaplasty is combined with a facelift, and the facelift page compares every option. The facelift combinations with neck work are:
- Lower facelift. A deep plane facelift with lateral neck lift, plus a standard neck lift. It treats the jowls, jawline and front of the neck together.
- Deep plane facelift with deep neck lift. Used instead where deeper neck structures contribute.
- Vertical Restore Facelift. The deep plane face and neck lift, with a standard or deep neck lift as assessment indicates, combined with a brow lift, eyelid surgery, upper lip lift and fat grafting.
Where the jowls have changed but there are no platysmal bands or fullness under the chin, a short scar facelift may be enough. A chin implant can sometimes be added where chin projection contributes.
Choosing a Surgeon for Platysmaplasty
Check the register. Only a medical practitioner with specialist registration in surgery, obstetrics and gynaecology, or ophthalmology may use the title “surgeon”, including “cosmetic surgeon”. Registration and specialty can be confirmed at no cost on the AHPRA register at ahpra.gov.au. Dr Scott J Turner is a Specialist Plastic Surgeon, AHPRA registration MED0001654827, and was awarded Fellowship of the Royal Australasian College of Surgeons (FRACS) in 2013.
Ask where the surgery is performed. Platysmaplasty with a facelift should be performed in an accredited hospital with a specialist anaesthetist. Dr Turner holds privileges at Bondi Junction Private Hospital, Delmar Private Hospital in Dee Why, and East Sydney Private Hospital.
Questions worth asking at consultation. Which layers of my neck are involved, and does the planned operation reach them? Is a standard or a deep neck lift planned, and why? Where will the incisions and scars be? Who provides after-hours care if a complication arises?
Understand the pathway. A referral from your GP or another registered medical practitioner is required before your first consultation. Two consultations with Dr Turner are required before surgery, the first of which can be by video and the second in person, and a seven-day cooling-off period applies before surgery can be booked or a deposit paid. Dr Turner screens for psychological factors such as body dysmorphic disorder and refers for further assessment where indicated.
Further guidance on assessing a surgeon is set out in choosing your surgeon.
Who May Be Suitable for Platysmaplasty?
Because platysmaplasty is performed with a facelift, suitability is usually that of a lower facelift: changes around the jowls and jawline together with platysmal bands or fullness under the chin, assessed at consultation. Patients who may be suitable are generally in good health, at or near a stable weight, and non-smokers or willing to stop all nicotine, including vapes, for a defined period before and after surgery.
Platysmaplasty may not be appropriate where medical conditions are not well controlled, where expectations go beyond what surgery can change, or where the assessment points to a different procedure. Younger adults with inherited fullness under the chin and no facial descent are usually assessed for neck liposuction, a deep neck lift or a direct neck lift instead. Age alone does not decide suitability, and older patients in good health can be suitable.
Platysmaplasty Recovery
Recovery follows that of a lower facelift and varies with general health, the procedures performed and individual healing. As a guide:
- First 24 to 48 hours. An overnight hospital stay, with the head elevated and discomfort managed with prescribed analgesia. Drains, if used, are removed within this period.
- First week. Swelling and bruising build and peak, with a review at day 3. Tightness under the chin is expected.
- Weeks one to two. Sutures are removed in stages from the day 7 review, and swelling begins to settle.
- Weeks two to three. Many patients return to desk-based work.
- Weeks three to four. Light exercise resumes with Dr Turner’s approval, and strenuous exercise is reintroduced gradually after that.
- Months three to six. Residual swelling settles, and scars continue to mature over the first year.
Dr Turner also consults in Canberra, Newcastle and Brisbane, and surgery is performed in Sydney. Patients travelling from outside Sydney are advised to stay in Sydney for 7 to 10 days after surgery, which covers the day 3 and day 7 reviews; see out-of-town patients. The lower facelift recovery timeline and the neck lift recovery guide cover each stage in more detail.
How Long Results Last
How long a result lasts varies between patients. Skin quality, weight stability, sun exposure, smoking history, general health and the extent of change before surgery all influence it, and expected duration is discussed against your own anatomy at consultation rather than quoted as a figure.
Ageing continues after surgery: the skin keeps changing, and some patients develop laxity or bands again over time.
Platysmaplasty Risks and Complications
All surgery carries risk. Complications discussed at consultation include:
- Haematoma. A collection of blood under the skin, which may need a return to theatre.
- Nerve injury. Injury to the marginal mandibular branch of the facial nerve can weaken the lower lip. It is usually temporary; permanent weakness is rare.
- Infection and wound healing problems. Wound healing problems are more likely in patients who smoke or use nicotine in any form, including vapes.
- Seroma, a collection of fluid that may need drainage.
- Contour irregularity or asymmetry, particularly while swelling settles, including central hollowing beneath the chin (cobra neck deformity) if too much fat is removed.
- Scarring. The incision under the chin and the facelift incisions are placed in skin creases and along the hairline where possible, but scars vary between patients, and hypertrophic scarring is possible.
- Residual fullness where structures beneath the platysma contribute and were not treated.
- Recurrence of bands or laxity, or a result that does not meet expectations, which may lead to further surgery.
- Numbness and tightness, which usually lessen over weeks to months.
Because platysmaplasty is performed with a facelift, the risks of the facelift also apply, and they are listed in the lower facelift risks. The general risks of anaesthesia are also discussed. Further information is on the risks and complications page and in the neck lift scars guide.
Platysmaplasty Cost in Sydney
Platysmaplasty is not priced on its own, because Dr Turner performs it as part of a facelift. The fee is for the combined operation and reflects theatre time, surgical complexity and the procedures combined. It has three parts: the surgeon’s fee, the specialist anaesthetist’s fee and the private hospital fee, including the overnight stay, and it covers the scheduled post-operative reviews.
The fee for each facelift combination, including a standard or deep neck lift, is set out on the facelift cost page, with a fee calculator. A written, itemised quote is provided after consultation.
Platysmaplasty performed for cosmetic reasons is not covered by Medicare or private health insurance. The $450 consultation fee, travel and accommodation are separate.
Before and After Photos
Photographs of Dr Turner’s own Sydney facelift patients, including patients who had neck surgery as part of their facelift, can be viewed in the facelift before and after gallery. They are taken under consistent lighting, angle and framing and published with patient consent. Results shown are individual and are not a prediction of outcome.
Frequently Asked Questions
Is platysmaplasty the same as a neck lift?
Platysmaplasty is one kind of neck lift: the repair of the platysma muscle at the front of the neck, often called the standard or traditional neck lift. “Neck lift” also covers a lateral neck lift, a deep neck lift, a direct neck lift and neck liposuction, which treat different layers or areas, as set out on the neck lift page. In Dr Turner’s practice, platysmaplasty is performed as part of a facelift.
Can platysmaplasty treat neck bands?
Yes, where the bands come from separation of the platysma in the midline. Platysmaplasty sutures the separated edges together, which is intended to treat the cause of the banding. Where bands are accompanied by fullness beneath the platysma, a deep neck lift is used instead. Suitability is assessed at consultation.
Can the platysma muscle be tightened?
Yes, surgically. In a platysmaplasty, the separated edges of the platysma are sutured together in the midline, and in every deep plane facelift the side of the muscle is suspended (the lateral neck lift). Non-surgical treatments may change skin quality, but they do not repair a separated muscle.
What is the difference between medial, lateral and corset platysmaplasty?
They are suture techniques rather than separate operations. Medial platysmaplasty sutures the separated edges of the platysma together in the midline. Lateral platysmaplasty suspends the muscle at the side of the neck and is the lateral neck lift included in every deep plane facelift. Corset platysmaplasty uses a running suture along the midline, which may be used where banding is heavier. The combination is chosen at surgery.
Is platysmaplasty the same as cervicoplasty?
Not quite. Platysmaplasty is the repair of the platysma muscle, while cervicoplasty refers to removing and redraping neck skin. The two are often performed in the same operation, and the terms are sometimes used loosely as if they mean the same thing.
Can platysmaplasty be performed on its own?
Dr Turner performs platysmaplasty as part of a facelift rather than as an isolated operation, because the lower face and neck usually change together. Without a facelift, central platysmal bands where the lower face is stable are treated through a direct neck lift, and fullness beneath the platysma through a deep neck lift.
When is a deep neck lift needed instead of platysmaplasty?
When the fullness comes from beneath the platysma: subplatysmal fat, prominent submandibular glands or bulky anterior digastric muscles. A standard neck lift does not reach these structures, so performing it alone is likely to leave the fullness. With a facelift, a deep neck lift takes the place of the standard neck lift.
Where are the incisions placed for platysmaplasty?
A small incision is placed in the crease under the chin. Because platysmaplasty is performed with a facelift, there is also the facelift incision, which runs in front of and behind the ear along the temporal and occipital hairlines, and through which loose neck skin is redraped. Scars vary between patients, and the neck lift scars guide covers how they heal.
Does platysmaplasty remove loose neck skin?
The platysmaplasty itself repairs the muscle. When it is performed with a facelift, loose neck skin is redraped and trimmed through the facelift incisions. How much skin can be treated this way, and whether another approach is needed, is assessed at consultation.
How much does platysmaplasty cost in Australia?
Platysmaplasty is not priced on its own, because Dr Turner performs it as part of a facelift. The fee for the combined operation reflects theatre time, surgical complexity and the procedures combined, and is made up of the surgeon’s, specialist anaesthetist’s and private hospital fees. The fee for each facelift combination, including a standard or deep neck lift, is on the facelift cost page, and there is no Medicare rebate or private health insurance benefit for cosmetic surgery.
Related Guides
- Neck procedures: Neck Lift, Deep Neck Lift, Direct Neck Lift, Neck Liposuction and Chin Implants
- With a facelift: Facelift, Lower Facelift, Short Scar Facelift, Deep Plane Facelift and Facelift Cost
- Reading more: Platysmal Bands: Causes and Treatment, Traditional vs Deep Neck Lift, Neck Lift Recovery: Week-by-Week Timeline and Neck Lift Scars
- About: Dr Scott J Turner, Specialist Plastic Surgeon
