Modified Medial and Lateral Platysmaplasty.

Abstract

In our previous anatomic study, the authors could pull the platysma effectively in the medial direction, lateral direction, or both the medial and lateral directions. In this paper, the authors analyzed the results of our series of modified medial and lateral platysmaplasties, in which the technique was based on Hamra's platysmaplasty, modified in light of Feldman's corset platysmaplasty and Mendelson's concepts.In medial platysmaplasty, subcutaneous dissection was performed from the mandibular border to 2 or 3 finger breadths above the xiphoid process. Lateral platysmaplasty required only peri-lobular subcutaneous dissection for exposing and anchoring the lateral border of the platysma to the preauricular platysma auricular fascia (PAF). Lateral dissection does not go beyond the occipital hairline. During dissection, the zygomatic retaining ligaments were detached and repositioned and anchored to the lateral side of the PAF using 4-0 sutures. One hundred sixty-eight patients underwent platysmaplasty (87 medial platysmaplasty, 76 lateral platysmaplasty, 3 isolated neck lift).The follow-up period ranged from 1 month to 156 months. In general, medial platysmaplasty was more efficacious than simple lateral pulling back for various conditions involving neck deformities, especially midline bands and severe submental fullness with skin laxity. The complications were 1 case of neuropraxia of the cervical branch (0.6%), 3 cases of hematoma (1.8%), 2 cases of seroma (1.2%), and 2 cases of submental depression (1.2%). All patients had temporary paresthesia around the periauricular area, but fully recovered by 6 months.Using this modified medial and lateral platysmaplasty, we obtained satisfactory results with low complications.