Continuing medical education examination—facial aesthetic surgery Importance of the digastric muscle in cervical contouring: an update

Abstract

Learning Objectives: The reader is presumed to have a broad understanding of plastic surgical procedures and concepts. After studying this article, the participant should be able to: 1. Make the diagnosis of hypertrophied anterior belly of the digastric muscle contributing to excessive bulging in the anterior neck. 2. Understand a method of treating the hypertrophied anterior belly of the digastric muscle. Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material covered in this article. The examination begins on page 17. Background: A well-contoured neck is essential for a youthful appearance. Prominence of the anterior bellies of the digastric muscles can cause or contribute to an objectionable bulge in the upper neck. Until recent years, contour problems resulting from the digastric muscle have been overlooked because accurate preoperative diagnosis is difficult. Objective: The purpose of this article is to present an update on a procedure initially reported by the first author in 1983. Methods: To achieve a youthful and aesthetically pleasing neck and submental contour, tangential excision of up to 90% of the inferior portion of the anterior bellies of the digastric muscles may be required. The procedure involves piercing the muscle belly with a long hemostat adjacent to the objectionable bulge of muscle, followed by transection of the excess muscle at the symphysis and near the sling. Results: The procedure has been performed in 103 patients with great improvement in cervical contour and no morbidity. Conclusions: The procedure presented is a simple, effective way to treat patients with submental bulges resulting from prominence of the anterior bellies of the digastric muscles.