Platysma Thickness Change with Age: A Retrospective MRI Study

Purpose Platysma bands are among the earliest visible signs of neck aging, yet the mechanisms underlying their development remain debated. This study aimed to evaluate age-related changes in platysma thickness using axial MRI, with attention to the modifying effects of gender. Methods A retrospective review of 200 MRI neck scans from patients aged 18–99 years was conducted at two tertiary centers. Platysma thickness was measured bilaterally at six anatomical levels using standardized radiological protocols. Associations with age and gender were assessed through correlation analysis, group comparisons, and multivariable generalized linear models. Results Platysma thickness demonstrated a progressive, statistically significant decline with advancing age across all measured sites (p < 0.001), most pronounced at the hyoid and infrahyoid levels. Males consistently exhibited greater muscle thickness than females (p < 0.001), a difference that persisted after adjustment for age. Multivariable regression confirmed that both increasing age and female gender were independently associated with reduced platysma thickness. Conclusion This study provides MRI-based evidence of age-related platysma atrophy, particularly in regions critical for neck contour. These findings suggest that structural muscle degeneration contributes substantially to neck aging and support incorporating imaging metrics into individualized aesthetic assessment and treatment planning. Consideration of both age and gender may enhance the precision of surgical and nonsurgical rejuvenation strategies.