What it means for a patient
- Neck bands can return after a neck lift if free muscle edges are left. This technique sews the edges together along the whole neck to avoid that.
- The same stitching is used to flatten bulging saliva glands under the jaw.
- Ask your surgeon how they treat the platysma and whether they sew it in the midline.
- The abstract gives no rates of bands returning or complications.
Why this paper matters
It described a full-length midline platysma suture meant to avoid recurrent bands, gland bulges and contour problems seen with other methods.
Overview
Most neck lifts tighten or cut the platysma muscle, but common methods can leave recurring muscle bands, visible submandibular gland bulges and contour irregularities. The author developed corset platysmaplasty to avoid these problems. The paper describes the technique and who it suits, based on 75 patients.
Findings
- Common methods: upper midline plication, muscle resection or transection.
- Their shortcomings: persistent or recurrent bands beside the midline, visible submandibular gland bulges, contour irregularities.
- Technique: after fat removal above and below the platysma, the two inner muscle edges are joined with a continuous suture running down, up and down almost the full height of the neck.
- This creates a smooth, flat, multilayered seam with no free muscle edges to form bands.
- Progressive side-to-side tightening along the seam defines the "waistline" of the neck.
- Added sutures below the jaw create flat vertical muscle pleats that correct gland bulging and refine the jawline and side of the neck.
- Indicated for all patients with visible bands beside the midline, and those needing the upper neck platysma opened for fat removal beneath it, including necks suggesting a short platysma or low hyoid.
- 75 patients; most followed 1 to 3 years.
Terms
- Platysmaplasty: surgery to tighten or reshape the platysma muscle.
- Platysma: the thin muscle over the front of the neck.
- Paramedian bands: vertical cords beside the midline of the neck.
- Plication: folding and stitching tissue to tighten it.
- Submandibular gland: a saliva gland under each side of the jaw.
- Lipectomy: surgical removal of fat.
- Decussated platysma: muscle fibers that cross over each other in the upper neck.
- Hyoid: a small U-shaped bone high in the front of the neck.