Platysmaplasty Facelift

Excerpt

Platysmaplasty is a rejuvenation procedure performed to increase the definition of the neck from the angle of the jaw down to the chin, thereby restoring a youthful and aesthetic contour to the face. It is generally indicated in persons between 40 and 60 years of age, and for those who want improved jaw and neck definition. It is not suitable for patients above 60 years of age who have significant excess skin and fat in the neck. For these patients, other procedures, such as face-lifting and liposuction, have to be added along with a plastymaplasty. However, platysmaplasty is most commonly performed in conjunction with a full cervicofacial rhytidectomy, in which the aim is to improve everything below the lower eyelids and down to the clavicles.

Bourguet (1928) was the first to describe a variation of the modern-day platysmaplasty, wherein he used a sub-mental incision to divide the prominent platysma muscle. Skoog (1969) reported a one-layer neck-lift in which the skin, subcutaneous tissue, and platysma muscle were suspended up through a lateral face-lift incision. Guerro–Santos (1978) first described lateral imbrication of the platysma to the fascia of the sternocleidomastoid muscle and mastoid periosteum. Feldman (1988) pioneered the technique of corset platysmaplasty, in which the two halves of muscle were sutured together and further cinched and shaped to recreate a youthful aesthetic neckline. Fuente del Campo (1998) published the “hammock platysmaplasty” technique, employing a double-breasted type of plication of the platysma to the contralateral mastoid fascia.

There have been many other variations of these initial techniques which involve the use of fascia, meshes, small-incision insertion of supporting sutures, and small-incision platysmal plication with subcutaneous plasma injection to incite skin contraction.