Jawline Contouring Over Time: Submental Platysmal Plication, Then a Lower Facelift and Neck Lift

She disliked how little definition she had along her jawline. She wanted a clearer contour beneath her chin, but that didn’t mean she needed a facelift at that stage. The first image shows her before treatment. The second shows her after an isolated submental platysmal plication. The third image shows her before the facelift, ten years after the plication. The final image shows her after the lower facelift and neck lift. Initially, I recommended an isolated submental platysmal plication to tighten the platysma muscle beneath her chin and improve the contour between her jaw and neck. It addressed the area that bothered her while allowing us to reserve a more extensive lift for later. In her case, that next step came ten years later. As her concerns evolved, I performed a lower facelift and neck lift to address tissue descent along the jawline and increased skin laxity, as well as a full facelift. As you can see from the images, the submental platysmal plication held up. What makes this sequence useful is that each procedure had a purpose. The first addressed a localized contour concern. The later surgery addressed changes that required more extensive correction. For younger patients seeking a more defined jawline, an isolated submental platysmal plication can be an option when muscle laxity beneath the chin is a key concern and excess skin is limited. The procedure can be done in the office under local anesthesia. Age alone doesn’t determine the procedure. I look at the muscle, skin, and deeper tissues to decide what will meaningfully improve the contour. This patient went ten years between procedures. That is her individual treatment history, not a promised timeline. My approach is to recommend the surgery that fits the anatomy and the patient’s goals at each stage.