Platysmaplasty: surgery for a youthful neck

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– an operation aimed at tightening excess skin of the neck, correcting neck wrinkles and strengthening the sagging median muscle of the neck (platysma). As a result of the natural aging process of the body, tissues gradually lose turgor under the influence of gravity and slowing metabolic processes. The oval of the face loses its former sophistication, a “double chin” and “double chin” appear. All these age-related problems are solved by neck rejuvenation surgery.

Technique:

• Neck (double chin) plastic surgery
  is also called platysmoplasty for a reason.
  It is with platysma
  the main work of a plastic surgeon occurs. Platysma is a wide fan-shaped muscle that is located from the chin to the collarbone. You can get to it using a small incision under the chin. As a result of the operation, the muscle is tightened, moved and fixed in a new position, due to which the restoration of a beautiful contour is achieved. If there is excess adipose tissue, liposuction of the neck (in other words, liposuction of the chin) is performed simultaneously (that is, simultaneously).


In adulthood, a double chin (in medical terms, an obtuse cervical-mental angle) usually appears either as a result of excess fat deposits or as a result of weakening and sagging of the neck muscle (plasticism). During surgical correction of the double chin, the muscle is cut at the apex of the cervical-mental angle and pulled towards the center. It turns out that the seam runs right down the middle. The incision under the chin is about 4 cm long. The middle part of the plasty is pulled through it. The incision leaves a small scar, which becomes almost invisible after 8-12 months.

Very often, platysmaplasty is included in a complex of facial rejuvenation operations.

(the so-called total anti-aging plastic), that is, it is performed simultaneously with SMAS plastic, circular plastic or endoscopic face lifting. In this case, the incision is made along the tragus of the auricle and a more extensive face and neck lift is performed.

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• Circular plastic
  and SMAS plastic are highly effective methods of lifting the neck and eliminating age-related excess facial tissue. These operations provide a clear effect of external rejuvenation even in very elderly patients, when the problem is not only the double chin, but the neck has an unaesthetic appearance that can no longer be changed by cosmetic procedures. With a circular lift, the doctor makes a longitudinal incision around the ear, the skin is peeled off in a certain area, pulled up to the back of the head, then fixed in a more tightened position, and the excess flap of skin is removed. The operation is usually performed under general anesthesia and lasts 2-3 hours. After this, it is very important to follow all rehabilitation recommendations. The first days you need to wear a special compression mask. Then for several months you will have to refrain from playing sports, visiting the solarium, or the beach.
• SMAS lifting
  also involves skin peeling and tightening. Only in this case, the tissues are cut more deeply, capturing the underlying muscle-fascial layer. Thus, wrinkles and excess tissue are reduced not only by reducing the amount of skin, but also by tightening the muscle frame.
• If the wrinkles on the neck are quite pronounced, but it is too early to resort to surgical methods of correction, minimally invasive procedures
  .

In our clinic, neck lifts for men and women can also be performed using APTOS threads, which give very good quick results for minor neck deformities and serve as a measure to “prevent” age-related changes. The recovery period after a neck lift with APTOS threads is much shorter

than after classical surgery.
However, such lifting is possible with small excess tissue in the problem area. Aptos threads are made of polypropylene or polylactic acid. They have tiny notches on them. Through barely noticeable punctures in the skin, the threads are pulled through the soft tissue. Thanks to the notches, they are fixed under the skin, forming a frame. Thus, soft tissues are tightened and external sagging disappears. Most often, the following types of threads are used for neck lifting: Aptos Needle 3/0, 2/0, Aptos Needle 2G, Aptos Wire.
The procedure for cutting wrinkles (Aptos Wire) is carried out with a special wire scalpel. At the location of the wrinkle, in its deepest part, there are strands. These are subcutaneous seals that are attached to deeper tissues. It is impossible to eliminate them with superficial procedures. During the undercutting operation, using a thin needle, a wire scalpel is inserted under the skin to a depth of 5-7 mm and sections of the skin-fat flap are targeted in the area of ​​the cord. As a result, the compaction in this place is leveled out and the depression disappears.

Recovery period

As a rule, the patient spends the first two days in the hospital, after which he can be discharged home. In general, rehabilitation lasts 2–4 weeks, but most often on the 10th day after surgery, the suture becomes almost invisible, therefore, it is already possible to evaluate the primary result. The final result can be judged only after 2–3 months.

After discharge, the doctor will definitely give detailed recommendations for the recovery period.

Their essence boils down to the following:

• wear an elastic bandage;
• avoid visiting baths and saunas in the first 2 weeks;
• do not sunbathe for the first 2 weeks;
• treat sutures with medications prescribed by a doctor;
• try not to catch a cold during the recovery period;
• to unload the neck muscles, sleep on your back;
• Do not put stress on the neck muscles for 2–4 weeks;
• Do not drink alcohol for 2 weeks;
• Do not take any medications without consulting your doctor.

Rehabilitation period:

Recovery after platysmaplasty takes up to 14 days - during this time bruises completely resolve and swelling goes away. Among other things, you must follow a gentle regime for 30 days - abstain from fitness, saunas, and sunbathing. It is recommended to wear a tightening compression mask for two weeks to a month (don’t take it off for about one week, then put it on at night). It is recommended to wash your hair with warm, but not hot water, and dry with cool air. The first hair wash should be agreed upon with your surgeon. For a faster recovery, it is recommended to undergo a course of post-operative rehabilitation.

NECK LIFT - OPERATION, METHODS

Plastic surgery of the neck is carried out in several stages:

• platysmoplasty (tightening of the neck muscles - performed if indicated),
• liposuction of excess fat deposits in the neck and double chin,
• tightening of the skin of the neck and lower third of the face.

As you can see, correction can affect not only fatty tissue and skin, but also the neck muscles (platysma). Taking this into account, neck plastic surgery can be performed in various ways:

Neck lift without incisions

A neck lift can be performed virtually “without a scalpel” (through punctures or very small incisions) if:

• you want to get rid of fat deposits in the neck and double chin area,
• your skin does not sag and has good turgor.

In order to remove excess fat from the neck, it is enough to perform liposuction. In young women, after removing fat deposits, the skin can tighten on its own. To enhance this effect, non-surgical methods of soft tissue tightening (hardware, thread lifting, etc.) can be recommended.

Neck lift without platysmoplasty

If we want not only to remove excess fat in the neck and double chin, but also to tighten the skin (eliminate sagging, folds and wrinkles), liposuction should be complemented by tightening the skin of the neck and lower third of the face (or a circular face and neck lift).

Please note that skin tightening on the neck cannot be performed separately. Neck plastic surgery always includes a lift of the lower face area.

Neck lift with platysmoplasty

If age-related changes have led to weakening and ptosis of the muscles, then a neck lift should include not only liposuction of fat deposits and tightening of the skin on the neck, but also muscle tightening (platysmoplasty), which can be performed both traditionally and endoscopically (see article “ Endoscopic facelift” – here).

But you should not insist on muscle tightening if there is no direct indication for it! Platysma plastic surgery, done unnecessarily and without taking into account individual characteristics, can cause a number of problems, including difficulty breathing and a constant feeling of tightness in the neck (especially in patients with thyroid pathology).

Dr. Kudinova is fluent in all of the above methods. In combination with her original “hidden stitch” technique, neck lift operations performed by Ekaterina Sergeevna give excellent long-term results.

Kudinova Ekaterina Sergeevna

Candidate of Medical Sciences, certificates in plastic and maxillofacial surgery. International expert in face and neck lifts, eyelid surgery, eyebrow surgery, chin surgery, etc.

To learn more

The result of platysmaplasty surgery or how to remove a double chin?

Double chin plastic surgery returns the youthful oval of the face, restores skin elasticity, and the so-called double chin disappears. If the problem of a double chin bothers young people and the cause of its appearance is an anatomically sloping chin, then mentoplasty will help solve the problem. In this case, silicone or cartilage facial implants are installed in the chin area.

A double chin, which is formed by fatty tissue, can only be removed using surgical methods. But you can improve the condition of the skin on your neck and make it more elastic without resorting to surgery. For this purpose, various minimally invasive anti-aging techniques have been developed. They are based on the stimulation of their own regenerative processes in skin cells in order to renew the tissues of the upper epithelium and dermis. The most common methods are peeling and plasma lifting. Peeling

is a procedure that removes the top layer of dead skin cells.
Accordingly, the underlying tissues accelerate regenerative processes and the skin is renewed, fine wrinkles are smoothed out. Plasmolifting
is a more invasive cosmetic procedure. Under the skin in the neck area (if necessary, also on the face and décolleté), the patient is given a series of injections of plasma obtained from his own blood. Unlike filler injections, during plasma lifting nothing foreign enters the patient’s body. Blood plasma also provokes an increase in regenerative processes and promotes natural rejuvenation of the skin.

Preparation for surgery

In order for the operation to proceed without complications, it is necessary to prepare for it:

• Find out the presence of possible contraindications - the patient must get tested and tell the doctor about the medications he is taking.
• The doctor must assess the level of elasticity of the patient's skin, the location and condition of the platysma, the size and location of the salivary glands, and the amount of adipose tissue under the chin.
• The patient must clearly describe his expectations, and the doctor must explain what is possible and what is not.
• The doctor must explain to the patient about the prices, the results of the intervention, the rules of the recovery period, and, if necessary, offer simultaneous correction of other areas.

A comprehensive examination before surgery includes:

1. undergoing an ECG;
2. fluorography;
3. blood and urine tests;
4. consultation with a therapist, and in the presence of chronic diseases, consultation with specialized specialists will be required.

2 weeks before surgery, the patient should avoid:

• undergoing cosmetic procedures;
• use of cosmetics;
• active physical activity;
• smoking.

In addition, the patient may be prescribed certain medications. If the patient takes any medications on an ongoing basis, he should tell the doctor about them, perhaps the doctor will decide to discontinue them or adjust the dosage.

In the first week after neck plastic surgery, pain is possible, so the doctor may prescribe painkillers.

Bely Igor Anatolyevich plastic surgeon, Doctor of Medical Sciences

NECK LIFT: HOW THE OPERATION IS PERFORMED

A neck lift is performed under general anesthesia. The correction technique, procedure and course of the operation depend on the condition of the tissues of the cervical-mental area, the individual characteristics of the patient and the goals of correction. The operation on average takes from 1 to 3 hours or more (depending on the amount of correction). Neck tissue lifting is always carried out in conjunction with corrections of the adjacent (lower) area of ​​the face.

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Planning the operation

During a face-to-face consultation, a plastic surgeon assesses the need for neck lift surgery and plans the scope of the upcoming surgical intervention. During the examination of the patient, the surgeon evaluates the following components:

• the presence of excess skin and subcutaneous tissue, the elasticity of the skin is assessed, and during the conversation, unfavorable factors affecting the violation of the patient’s skin turgor are identified;
• the condition of the anterior edges of the subcutaneous muscle of the neck is assessed, their projection, symmetry of tension, degree of sagging;
• “opening” of the cervical-mental angle;
• projection and shape of the chin (underdevelopment of the chin reduces the severity of the effect after a neck lift);
• position and size of the submandibular salivary glands.

Indications

Plastic surgery is not performed for medical reasons, but for the purpose of beauty.
The expected result is neck rejuvenation (from the chin to the décolleté) by tightening the skin and underlying muscle. Up to 40-50 years of age, you can maintain the tone of this area without surgery using special products that provide deep nutrition. Subsequently, against the background of natural aging processes, tissues begin to deform:

• the connective tissue frame is weakened;
• the thickness of subcutaneous fat increases;
• turgor decreases;
• the epidermis becomes thinner and dehydrated;
• The platysma “sags”, its edges diverge.

When should you contact a plastic surgeon?

1. distortion of the contours of the chin-cervical angle;
2. flabbiness;
3. the appearance of folding (“rings of Venus” or “turkey cords”);
4. "double chin;
5. loss of overall attractiveness.

The listed phenomena cannot be eliminated by special procedures or gymnastics. Injection techniques can somewhat slow down the aging process, however, this method cannot be called unconditionally effective.

Radical rejuvenation of the face and neck is possible only with the help of a surgical lift, which is rightly often called “Hollywood”.