01
About Submental Platysmal Plication
Dr. Trott performs the procedure in her Beverly Hills office under local anesthesia. It is a real surgical operation, done through a small incision beneath the chin, and it is aimed at one specific finding: laxity in the muscle layer, where the skin above it still holds.
02
Ideal Candidates
The most common patient in this conversation is a man in his 30s, 40s or 50s whose neck has begun to soften beneath the chin, and who does not yet need, or does not yet want, a deep plane neck lift. Dr. Trott has treated patients who wanted a tighter neck and a more defined jawline but were not ready for a full neck lift, and plication met them where they were.
Candidacy is decided by the anatomy, not the birth year. She looks at three things: how lax the platysma is, how much excess skin there is, and how much fullness sits in the deeper tissues. Where muscle laxity is the dominant finding and excess skin is limited, plication can be the right operation on its own. Where loose skin is the dominant finding, tightening the muscle alone will not produce the result the patient is describing, and Dr. Trott says so at the consultation rather than in the operating room.
03
Surgical Technique
The operation is performed in the office under local anesthesia, with the patient awake. The incision is placed beneath the chin, in the natural shadow of the submental area, where a beard line or a short haircut keeps it out of view. Because the work is confined to this one area, there is no general anesthesia and no overnight stay.
Through that access Dr. Trott tightens the platysma muscle along the midline, placing sutures along a span of roughly 4 to 6 cm. Where fat contributes to the fullness beneath the chin, it is addressed in the same session. Where the skin is lax but a lift is not yet warranted, she frequently combines plication with Renuvion skin tightening, because the muscle and the skin are separate problems: the plication rebuilds the support underneath, Renuvion treats the skin above it.
04
Recovery
Because the procedure is done under local anesthesia in the office, there is no recovery from general anesthesia to plan around. Swelling and bruising beneath the chin are expected and settle as the tissue heals. Patients leave with a written plan for activity, and high impact exercise is held off until the tissue has recovered enough to tolerate it.
What a patient should understand before the day: plication tightens the muscle, so the change in the underside of the chin is visible early, but the final definition depends on the skin and deeper tissue that remain above it. Dr. Trott reviews the specific plan and the expected recovery with each patient at the consultation.
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Submental Plication and the Deep Plane Neck Lift
This is the honest comparison, and Dr. Trott does not soften it: submental platysmal plication does not replace a deep plane neck lift in every case.
A deep plane neck lift repositions the deeper tissues of the neck and lower face and removes skin that has genuinely stretched. Plication tightens the muscle beneath the chin. They are not two versions of one operation, they are answers to two different findings.
What decides it is how much skin there is, how lax the muscle is, and how full the deeper tissues are. A patient whose concern is a soft, undefined line beneath the chin, with skin that still holds, is often a candidate for plication. A patient with a heavy lower face, descended tissue and true skin excess will not be satisfied by muscle work alone, and Dr. Trott would rather say that in the consultation than after surgery.
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Long Term
One patient in this gallery came to Dr. Trott because she disliked the lack of definition along her jawline. Dr. Trott recommended an isolated submental platysmal plication first, reserving a more extensive lift for later. Ten years later she returned for a lower facelift and neck lift, and the earlier plication had held.
That is one patient's history, not a promised timeline. What it shows is the logic of the approach: treat the structure that is actually failing, and leave the larger operation for the day it is genuinely needed.
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