Correcting A Sagging Jawline with Platysmaplasty

Written by Minas Constantinides, MD, FACS, Board Certified Facial Plastic Surgeon on November 9, 2015 7 Comments

platysmaplasty surgery

One of the most common and noticeable aspects of aging is sagging of the neck and jawline. This drooping occurs after years of gravity slowly pulling the muscles and skin in the chin and neck toward the ground.

Platysmaplasty surgery is an effective technique with the power to correct sagging skin and muscle, leaving the neck with a natural, sculpted and rejuvenated appearance.

Anatomy Lesson: Causes of Jawline Sagging

Anatomically, the neck and jawline are home to the platysma, a muscle which works to support the skin and fat of the neck. When a person reaches around age 40, the platysma begins to separate in the midline, resulting in the development of neck bands. At the same time many people will start experiencing the beginnings of fat loss from around the platysma.

As aging continues, the platysma continues to weaken while the separation from the midline and fat loss increases. The result is the development of neck bands and jowls, and an overall loss of jawline definition.

Interestingly, the fat that is deep to the platysma does not change with age, or weight loss, as much as the fat above the platysma and just below the skin. This is why some thin patients will still have fullness below their chins. As the platysma weakens and parts in the middle, this fullness becomes more obvious.

Not only does a sagging jawline affect the neck, but can also affect the lower face. Marionette lines and gullies at the corners of the mouth and chin form. Unfortunately, platysmaplasty has no effect on marionette lines; a facelift or camouflaging filler are the best treatments for these.

What is Platysmaplasty?

Platysmaplasty is a surgical procedure that can tighten a sagging platysma while simultaneously enhancing the contours between the neck and jawline, resulting in a tighter, more youthful-looking neck.

During platysmaplasty, a facial plastic surgeon makes a one-inch long incision in the midline just behind the chin crease. The skin is elevated off the platysma, allowing the surgeon full access to the platysma. The platysma is then reconnected in the midline and tightened with dissolvable sutures. The surgeon works to completely re-drape the muscle; pulling the platysma so it’s tight. Often, in heavier patients, liposuction of the neck is performed at the same time to allow for even better neck contour. When there is excessive fat beneath the platysma, that can also be surgically trimmed. This combination of procedures creates a flatter and firmer neck contour.

Basically the procedure is synonymous to lacing up a corset; both leading edges of the platysma are pulled together and sometimes overlapped, resulting in a smooth and taut muscle layer.

When platysmaplasty creates a lot of tightening, the excess skin must sometimes be removed from around the ears at the back of the neck. This more extensive surgery also can tighten the platysma from the back and is often referred to as a jawline and neck lift, or a lower facelift and neck lift, rather than just a platysmaplasty. This requires additional incision hidden around the earlobes. The length of the incisions varies according to how much tightening has been achieved.

Post procedure, patients may experience bruising and swelling along their neck and jaw as well as around the ears. However these symptoms should resolve on its own in a couple of days after the procedure. Most people sufficiently heal within 2 weeks, after which they can return to normal physical activity. Platysmaplasty surgery provides immediate results which can last for years.

Alternatives to Platysmaplasty

  • Injectables: Small to moderate platysmal bands can be relaxed using a botulinum toxin type A, like Botox or Dysport. Typically, 20 to 30 units of Botox are required to control neck bands and the results last three to four months.
  • Ultherapy: If the main problem is skin laxity, then non-surgical options like Ultherapy can tighten the skin without surgery.
  • Liposuction: If the problem is only heaviness without platysmal or skin laxity, then neck liposuction is a good alternative. This procedure has less than one week healing time and gives long lasting results in the right patients.
  • Kybella: A new non-surgical option for treating excess neck fat is Kybella, an injection that dissolves fat without surgery.

Are you currently experiencing mild, moderate or severe neck sagging or heaviness? Contact us today to learn more about platysmaplasty or schedule a free consultation.


Minas Constantinides, MD, FACS

Dr. Minas Constantinides is a board-certified Facial Plastic Surgeon at Westlake Dermatology & Cosmetic Surgery in Austin, Texas. He is on the Executive Committee of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and is a Senior Advisor of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS).

7 Responses to “Correcting A Sagging Jawline with Platysmaplasty”

  1. Avatar jordan says:

    Great article, thanks for this information. I will call for consultation.

  2. Avatar Zack says:

    I was wondering if you have any before and after photos of the platysmaplasty surgery

  3. Avatar Karen T. says:

    I’ll be coming in for a consultation next week. Looking to correct turkey neck and thinign of this procedure or lipo

  4. Avatar mema says:

    i had a PDO treatment at neck which was a disaster as the threads broke in my face causing pain to me and unnatural shapes to my face… but the worst is that they pulled my face down and now i have fat jowls, deep marionette lines and a strange chin with angles… i d like to ask if platysmaplasty corrects the jowls too..

    • WD Staff WD Staff says:

      Hi Mema, I’m very sorry to hear about your experience but we appreciate you sharing it and asking a great question on our blog. Platysmaplasty can correct the jowls, however the best course of treatment will always depend on the specific characteristics of each individual patient.

      We would encourage you to get an in-person consultation, if you are in the Austin area please fell free to give us a call at 512.328.3376 to set one up!

      Thanks again,
      WD Staff

  5. Avatar Dawn says:

    I will be in the Austin area visiting my mother next month. I plan to have a neck tightening surgery this year, and recover at her home. I will fly back for the procedure.
    Do you have an consult opening on the morning of February 22?
    Thank you,

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