Another Look at Platysmaplasty in Facelifting
Over the history of facial rejuvenation surgery there has been a progressive assimilation of knowledge about the anatomy of neck structures that are central to the manifestations of the aging neck. These advances in knowledge have been accompanied by the innovation and introduction of several surgical techniques to restore the neck to a more youthful appearance. The rejuvenation of the aging neck frequently incorporates a consideration and execution of accepted methods to restore the platysma muscles to a more aesthetic form. Lasting and dependable surgical techniques remain somewhat elusive and late failures in the neck continue to be a frustration for both patients and surgeons.
In this manuscript, the author reviews some of the more enduring and innovative methods to manage the platysma in facelifting and cites the rationale and limitations of the various techniques. The concept of the restoration of an effective platysma “sling” in the upper neck to eliminate platysma bands and recreate a defined jawline is highlighted. A framework of patient evaluation and decision making is presented, and a suggested individualized application of accepted surgical maneuvers is suggested.
31 August 2020 (online)
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
- 1 Marchac D. Julien Bourguet. The pioneer in aesthetic surgery of the neck. Clin Plast Surg 1983; 10 (03) 363-365
- 2 Skoog TG. Plastic surgery: the aging face. In: Skoog TG. , ed. Plastic Surgery: New Methods and Refinements. Philadelphia, PA: Saunders; 1974
- 3 Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 1976; 58 (01) 80-88
- 4 Fedok FG, Sedgh J. Managing the neck in the era of the short scar face-lift. Facial Plast Surg 2012; 28 (01) 60-75
- 5 Fedok FG. The rejuvenation of the aged central lower face: a contemporary perspective. Facial Plast Surg 2019; 35 (02) 121-128
- 6 Sinno S, Thorne CH. Cervical branch of facial nerve: an explanation for recurrent platysma bands following necklift and platysmaplasty. Aesthet Surg J 2019; 39 (01) 1-7
- 7 Dedo DD. The aging neck. In: Bailey BJ. , ed. Head & Neck Surgery – Otolaryngology. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998
- 8 Henley JL, Lesnik DJ, Terk AR. Contralateral platysma suspension: an adjunct to rhytidectomy. Arch Facial Plast Surg 2005; 7 (02) 119-123
- 9 de Castro CC. The anatomy of the platysma muscle. Plast Reconstr Surg 1980; 66 (05) 680-683
- 10 Trévidic P, Criollo-Lamilla G. Platysma bands: is a change needed in the surgical paradigm?. Plast Reconstr Surg 2017; 139 (01) 41-47
- 11 Furnas DW. The retaining ligaments of the cheek. Plast Reconstr Surg 1989; 83 (01) 11-16
- 12 Huettner F, Rueda S, Ozturk CN. , et al. The relationship of the marginal mandibular nerve to the mandibular osseocutaneous ligament and lesser ligaments of the lower face. Aesthet Surg J 2015; 35 (02) 111-120
- 13 Jacono AA, Malone MH. Characterization of the cervical retaining ligaments during subplatysmal facelift dissection and its implications. Aesthet Surg J 2017; 37 (05) 495-501
- 14 Labbé D, Franco RG, Nicolas J. Platysma suspension and platysmaplasty during neck lift: anatomical study and analysis of 30 cases. Plast Reconstr Surg 2006; 117 (06) 2001-2007 , discussion 2008–2010
- 15 Feldman JJ. Corset platysmaplasty. Plast Reconstr Surg 1990; 85 (03) 333-343
- 16 Feldman JJ. Neck lift my way: an update. Plast Reconstr Surg 2014; 134 (06) 1173-1183
- 17 Zins JE, Menon N. Anterior approach to neck rejuvenation. Aesthet Surg J 2010; 30 (03) 477-484
- 18 Jacono AA, Bryant LM, Ahmedli NN. A novel extended deep plane facelift technique for jawline rejuvenation and volumization. Aesthet Surg J 2019; 39 (12) 1265-1281
- 19 Berry MG, Davies D. Platysma-SMAS plication facelift. J Plast Reconstr Aesthet Surg 2010; 63 (05) 793-800
- 20 Gonzalez R. The LOPP-lateral overlapping plication of the platysma: an effective neck lift without submental incision. Clin Plast Surg 2014; 41 (01) 65-72
- 21 Connell BF, Gaon A. Surgical correction of aesthetic contour problems of the neck. Clin Plast Surg 1983; 10 (03) 491-505
- 22 Cruz RS, O'Reilly EB, Rohrich RJ. The platysma window: an anatomically safe, efficient, and easily reproducible approach to neck contour in the face lift. Plast Reconstr Surg 2012; 129 (05) 1169-1172
- 23 Rohrich RJ, Rios JL, Smith PD, Gutowski KA. Neck rejuvenation revisited. Plast Reconstr Surg 2006; 118 (05) 1251-1263
- 24 Marten T, Elyassnia D. Management of the platysma in neck lift. Clin Plast Surg 2018; 45 (04) 555-570
- 25 Batra AP, Mahajan A, Gupta K. Marginal mandibular branch of the facial nerve: An anatomical study. Indian J Plast Surg 2010; 43 (01) 60-64