Platysmal Bands Research Articles

Anatomical Proposal for Botulinum Neurotoxin Injection Targeting the Platysma Muscle for Treating Platysmal Band and Jawline Lifting: A Review.

The platysma muscle is a thin superficial muscle that covers the entire neck and lower part of the face. The platysma muscle is the primary target muscle for botulinum neurotoxin injection therapy aimed at treating platysmal band and lower facial lifting. In the procedure of botulinum neurotoxin injection therapy, a lack of knowledge of the anatomy of the platysma muscle and the properties of botulinum neurotoxin can lead to side effects such as dysphagia, dysphonia, and weakness of the neck muscles. Anatomically safe injection sites have been proposed for the platysma muscle, and the appropriate injection technique has been reviewed. We proposed optimal injection sites based on the external anatomical features of the mandible. The aim of these proposal was to standardize the procedure for the effective use of botulinum neurotoxin injections by minimizing the dose unit and injection points and thereby preventing adverse events.

A Rejuvenating treatment targeting "tech neck" lines and wrinkles in Chinese women: A prospective, open-label, single-center study.

Aging of neck and jawline skin is caused by intrinsic and extrinsic factors and is evidenced by wrinkling, laxity, skin dyspigmentation, loss of the mandibular contour, accumulation of submental fat, density loss, and prominent platysma bands. Early intervention with topical cosmeceuticals, especially in younger subjects with "tech neck," can offer a solution and potentially mitigate aging of the neck and jawline. The objective of this prospective, open-label, single-center clinical study was to assess the efficacy and tolerability of a topical anti-aging neck treatment (TNT) in a cohort of Chinese women with mild to moderate signs of aging on the neck and jawline. This study was approved by an ethics committee and involved healthy Chinese subjects. Thirty-five female subjects, 25-50 years old, with mild to moderate signs of aging of the neck and jawline were recruited. Subjects applied the TNT to the neck and jawline twice daily for 84 days. Long-term efficacy and tolerability, clinical photography, bioinstrumentation, and a self-assessment questionnaire were performed at baseline and post-baseline. The TNT significantly improved horizontal neck fold lines and neck skin elasticity, hydration, gloss/radiance, and skin tone evenness post-baseline. Clinical photography and ultrasound corroborated these findings. The product was well perceived and well tolerated by subjects. This study demonstrated the TNT was effective against both extrinsic and intrinsic aging of the neck and jawline. The TNT provides a topical solution for Chinese women concerned with an aging appearance of the neck including "tech neck."

The Underappreciated Role of the Platysma Muscle in the Perioral Expressions in Young Adults.

The platysma is involved in lower face movement, yet limited information on its functional role when making perioral expressions is available. The aim of this study was to use 3-dimensional (3D) photogrammetry to analyze platysma activity when making expressions. Standardized frontal-view 3D images were obtained from 54 volunteers. Three perioral expressions were analyzed: a full smile, mouth corner depression, and a grimace to show the lower teeth. Positive volume change in the "heat map" of the neck skin surface-determined by the superimposed image subtraction technique-served as a sensitive indicator of platysma contraction. When making the 3 expressions, the proportions of platysma contraction were 42.6%, 75.9%, and 92.6%, respectively. The platysma worked as a more critical dynamic force than expected. In most smiles involving the platysma, its upper portion contracted. With the laterally downward traction on the lower lip increasing, the upper and lower portions of the platysma contracted together and formed muscular bands. The platysma contracted extensively in the other 2 expressions. In some cases, platysma bands were observed to form due to vigorous contraction of muscle fibers. In addition, the platysma was found to be highly functionally active in young individuals. This study introduced a simple method that can sensitively identify the functional status of the platysma. The results showed the platysma's highly active function in perioral expressions in young adults. These findings may assist surgeons in personalized decision-making toward platysma muscle-weakening strategies and work as an objective tool for outcome evaluation.

Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments.

Many signs of aging manifest in the neck region, including platysmal bands, excess skin, horizontal neck lines and decreasing contour of the neck. While the clinical signs of an aged neck are well-known, data determining the underlying aging process are limited. To decode aging of the neck. This prospective study investigated elasticity and firmness of skin, muscle activity and skin displacement upon muscular contraction in the neck in 77 young-, middle- and old-age individuals. Objective outcome measures, including 3-dimensional imaging, cutometry and surface electromyography, were utilized for all assessments. Mean firmness of skin decreased significantly from young to old individuals (0.37 ± 0.13mm, 0.30 ± 0.12mm and 0.26 ± 0.12mm in young, middle and old subjects, respectively; p < 0.001). Gross elasticity decreased significantly from 75.1 ± 13.0% in young subjects, to 64.53 ± 15.7% in middle-aged subjects and 55.79 ± 13.0% in old subjects (p < 0.001). The mean y-axis skin displacement increased from 2.48 ± 4.33mm in young subjects, to 3.11 ± 4.49mm in middle-aged subjects and 3.61 ± 5.38mm in old subjects (p = 0.006). The mean signal-to-noise ratio decreased significantly from 16.74 ± 5.77µV in young subjects, to 14.41 ± 4.86µV in middle-aged subjects and to 12.23 ± 5.99µV in old subjects (p < 0.001). This study provides insights into the interplay between skin elasticity, muscular activity and the reflected movement of the skin of the neck. Appreciation of these age-related changes lays the fundament for aesthetic treatments in this delicate region. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Characteristic features of neck aging

In today’s era, everyone desires a youthful and beautiful look as they age. In this regard, many non-invasive and minimally invasive facial and neck rejuvenation procedures are most sought after by patients. Neck rejuvenation is of priority among patients in recent days as it significantly contributes to the overall aesthetic outcome. Therefore, as good dermatologists, we must have a sound knowledge of the anatomy of the neck, and various clinical signs of neck aging and choose the right modality of treatment with good acceptability and fewer adverse effects to obtain the desired aesthetic outcome. Neck aging is due to intrinsic as well as extrinsic factors and manifests as skin dyspigmentation, laxity, rhytides, loss of mandibular contour, widening of the cervicomental angle, accumulation of submental fat, volume loss, and prominence of the platysmal bands. A wide range of therapeutic options is available to address these concerns. In addition, it is also imperative to advise patients to follow a good skincare regime that includes moisturizers, sunscreens, and retinol creams to have a better outcome. It is the combination approach that often produces the most optimal outcome. The treatment plan for rejuvenation must be modified for every individual based on the degree of neck aging and their expectations.

The Effect of a Novel Platysma Hammock Flap During Extended Deep Plane Facelift on the Signs of Aging in the Neck.

Aging changes in the neck, including platysma banding (PB), skin laxity (SL), and submandibular gland visibility (SGV), have a high degree of recurrence after rhytidectomy. The authors sought to assess the long-term improvement in PB, SL, and SGV with addition of aplatysmal hammock flap to the extended deep-plane facelift and assess patient satisfaction. This was a prospective study of 123 consecutive patients undergoing extended deep-plane facelift incorporating platysma hammock flap with or without midline platysmaplasty. Standard 2-dimensional patient photographs were employed to assess PB, SL, and SGV preoperative and >12 months postoperative. A 1-year postoperative patient satisfaction survey was conducted. The platysmal hammock flap without midline platysmaplasty cohort had a significant (P < 0.01) reduction in mean preoperative PB, SL, and SGV scores from 1.03, 1.88, and 1.21 to 0.06, 0.03, and 0.15 at 21 months. The platysmal hammock flap with midline platysmaplasty cohort had a significant (P < 0.01) reduction in preoperative PB, SL, and SGV scores from 1.81, 2.43, and 1.81 to 0.10, 0.15, and 0.48 at 18 months. The platysmal hammock flap with and without midline platysmaplasty cohorts had 96.2% and 88.9% satisfaction, respectively. Extended deep-plane facelift with a platysmal hammock flap achieves long-term, sustained improvements in PB, SL, and SGV; is well-tolerated; and results in substantial patient satisfaction.

Facial Soft Tissue Repositioning With Neuromodulators: Lessons Learned From Facial Biomechanics.

Neuromodulators have proven efficacy in reducing facial rhytides and have also been reported to improve jawline contour and the appearance of platysmal bands. Lifting effects of the tail of the eyebrow are expected outcomes when targeting the lateral periorbital region, underscoring the versatility of neuromodulator treatments. The aim of this study was to analyze the clinical effectiveness of a novel neuromodulator-based injection algorithm with regards to its ability to reposition the middle and lower facial soft tissues. Seventy-five study participants (8 males, 67 females) with a mean [standard deviation] age of 37.5 [8.5] years were injected with neuromodulators in the subdermal plane of the mandibular soft tissues following a standardized algorithm. Live rating of clinical appearance was performed, as well as volume change and skin vector displacement measured by 3-dimensional imaging at baseline, Day 14, and Day 30. Three-dimensional volume analysis revealed an increase in midfacial volume by 0.46 mL, and a decrease of the lower facial volume by 0.30 mL compared with baseline. Additionally, an improvement of midfacial fullness (by 0.13) and jawline contour (by 0.44) was reported on clinical rating scales at Day 30 compared with baseline. Facial soft tissues can be repositioned during the 30-day follow-up period following a neuromodulator treatment; this was reflected through an increase in midfacial volume as well as through a decrease in lower facial volume. The novel injection algorithm presented can provide a safe and effective option for patients desiring improvement of midfacial fullness and jawline contour with neuromodulator treatment alone.

A retrospective analysis of the uses of BoNT-A in daily dermatological practice.

Botulinum toxin-A (BoNT-A) has been increasingly used in the cosmetic dermatology daily routine. The treatment areas of BoNT-A are glabellar lines, forehead wrinkles, periorbital lines (crow's feet), eyebrow lifting, perioral lines, platysmal bands, masseter hypertrophy, and hyperhidrosis. The aim of this study was to reveal the epidemiologic characteristics of the patients treated with BoNT-A and the frequencies of treatment areas. The patients were grouped into five categories: facial wrinkles, platysmal bands, masseter hypertrophy, axillary hyperhidrosis, and palmoplantar hyperhidrosis. Each patient received either onabotulinum toxin-A (diluted with 2cc saline) or abobotulinum toxin-A (diluted with 3cc saline) treatment. The patients' age, gender, and the total numbers of treatment received in each area were noted. SPSS version 21 was used for the statistical analysis. A total of 1614 patients were included: 165 (6.5%) male and 1509 (93.5%) female. There is no difference between genders in terms of treatment area (p=0.855). The number of treatment sessions is independent of the patients' gender (p=0.703). The mean age of the patients was 46.6years. There is a relationship between the patients' age and treatment area (sig 0.000). There is no relationship between the number of repetitive treatments and the patients' age (p=0.081). The number of repetitive treatments is dependent to the treatment area (p<0.001). Facial wrinkles, platysmal bands, and masseter hypertrophy are the most commonly treated areas. The treatment area is dependent on the age as platysmal bands are more commonly treated in older patients; however, no relationship between gender and treatment area was found. BoNT-A treatment for hyperhidrosis is not as commonly repeated as for that of cosmetic concerns.

OnabotulinumtoxinA from lines to facial reshaping: A new Italian consensus report.

Botulinum neurotoxin type A is the most widely used nonsurgical treatment for esthetic improvement of the face and neck. In 2015, an Italian consensus panel met to discuss the optimal methods for using onabotulinumtoxinA. However, clinical practice continues to evolve and the original report is now considered obsolete. To provide updated guidance on the esthetic uses of onabotulinumtoxinA in the face and neck. A panel of 10 Italian specialists (including plastic and maxillofacial surgeons, dermatologists, and esthetic doctors) individually completed a questionnaire on their own clinical practice, and then met to discuss their responses and agree on a revised treatment consensus. Recommendations are provided on patient assessment, reconstitution of onabotulinumtoxinA, and preferred procedures (injection sites, doses, anatomical targets, safety precautions, etc.) across a variety of treatment areas, including glabellar, crow's feet, and forehead lines; brow lifting and shaping; lower eyelid hypertrophy; bunny lines; sagging nasal tip; gummy smile; masseter hypertrophy; perioral lines; marionette lines and "sad mouth;" mentalis hypertonia; and platysma bands. Some of the recommended doses are substantially increased from the previous consensus (particularly in the upper third and masseter) for the purpose of achieving longer lasting results without affecting safety. Furthermore, two increasingly popular techniques-the Nefertiti lift and Microbotox-are included in the consensus for the first time. Optimal practice with onabotulinumtoxinA requires a systematic approach to maximize safety and effectiveness across the range of potential uses. The present consensus was developed to support these aims.

Hyaluronic Acid Compound Filling Plus Mesotherapy vs Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter, Randomized, Evaluator-Blinded, Prospective Study in Chinese Subjects.

BackgroundAlthough energy devices and botulinum toxin A (BTX-A) can alleviate age-related laxity, ptosis, and platysmal bands, they have limited efficacy on horizontal neck lines.ObjectivesThe purpose of this study was to investigate the efficacy, safety, and subject satisfaction of a combined treatment of non–cross-linked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, in comparison with BTX-A.MethodsThis multicenter, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either 2 or 3 sessions of of non–cross-linked HA compound filling plus mesotherapy or 1 session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated and compared at 1, 3, 6, and 10 months after the final treatment.ResultsTwenty-five patients received HA filling plus mesotherapy and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy significantly improved the horizontal neck lines grades on all follow-up visits (P = 0.000). Cases of different baseline grades (2, 2.5, and 3) demonstrated similar outcomes. The GAIS and patients’ satisfaction ratings were significantly higher for the HA filling plus mesotherapy treatment group (P = 0.000). Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious AEs occurred.ConclusionsCompared with BTX-A, combined treatment with HA compound filling plus mesotherapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction.Level of Evidence: 4

Discussion: Anatomy behind the Paramedian Platysmal Band: A Combined Cadaveric and Computed Tomographic Study.

Discussion: Anatomy behind the Paramedian Platysmal Band: A Combined Cadaveric and Computed Tomographic Study.

Anatomy behind the Paramedian Platysmal Band: A Combined Cadaveric and Computed Tomographic Study.

The muscular hypothesis explanation of the pathophysiology behind paramedian platysmal bands does not seem to provide a sufficient explanation for the clinical presentation of these platysmal bands in aged individuals with cervical soft-tissue laxity. The purpose of this study was to investigate the fascial relationships of the anterior neck to enhance appropriate surgical treatment. Retrospective analysis of computed tomographic scans of 50 Caucasian individuals (mean age, 55.84 ± 17.5 years) and anatomical dissections of 20 Caucasian and 10 Asian body donors (mean age, 75.88 ± 10.6 years) were conducted. Fascial adhesions were classified according to platysma fusion types, and platysma mobility was tested during dissection procedures. Fusion between the left and right platysma muscles occurred in 64 percent in the suprahyoid region and in 20 percent at the thyroid cartilage, and in 16 percent, the platysma attached to the mandible without fusion. In the absence of muscular fibers, a fascial adhesion zone with limited mobility was observed where the superficial cervical fascia fused with the investing layer of the deep cervical fascia. Muscular contraction of the platysma results in elevation of the most medial platysma muscle fibers, which are not attached in the fascial adhesion zone. The presence of a fatty layer deep to the platysma enables platysmal movement and anterior and inferior gliding of the skin and platysma when cervical soft-tissue laxity exists. Surgical treatments should include transection of the fascial adhesion; this could potentially prevent the recurrence of paramedian platysmal bands.

Role of botulinum toxin A in improving facial erythema and skin quality

Botulinum toxin A (BTX-A) injections have become the most popular noninvasive cosmetic procedures performed worldwide. With growing interest, investigators continue to uncover an expanding array of aesthetic indications for BTX-A. Botulinum toxin A has been used off-label in the management of masseter hypertrophy for facial slimming, platysmal bands, nasal 'bunny' lines, perioral rhytides, gummy smile and scars, to name a few. Interestingly, the injection of multiple microdroplets of dilute BTX-A into the dermis, sometimes referred to as 'microbotox', has been investigated as a tool for facial rejuvenation. A handful of prospective studies and case series have demonstrated the benefit of BTX-A in the treatment of facial erythema and improving skin texture. The aim of this review is to summarize and appraise currently available data on the role of BTX-A in treating facial erythema and skin quality, with a special focus on potential pathophysiologic mechanisms.

Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm

The neck is an often-neglected part of body lift procedures after massive weight loss. The objective of this study was to classify massive weight loss patients undergoing direct neck lift procedures and provide a standardized treatment algorithm. A retrospective review of all neck lift procedures performed between January of 2012 and December of 2019 was conducted. Patients were classified as follows: Grade I, no skin excess with remaining preplatysmal fat and no platysmal laxity; Grade IIa, moderate submental skin excess with subplatysmal fat deposits and platysmal laxity; Grade IIb, moderate anterior neck skin excess with no fat deposits and platysmal laxity; Grade III, considerable anterior skin excess with no or limited fat deposits and platysmal laxity and bands. Grade I patients had Liposuction, Grade IIa patients Submental Neck Lift with anterior fat excision and central platysmaplasty, Grade IIb Submental Neck Lift with central platysmaplasty, and Grade III patients Median Z-Plasty with fat excision (if needed) and central platysmal resection and tightening. Thirty-one patients were included for analysis. One underwent liposuction, twenty-five a Submental Neck Lift and five a Median Z-Plasty. Concomitant surgery was carried out in all cases. A recurrent skin laxity occurred in 2 (11.8%) patients, so in local anesthesia an operative revision was required. A standardized algorithmic approach for neck lift in massive weight loss patients may optimize the result without increasing the complication rate. Direct neck lift procedures prove to be reliable techniques with rare complication rates that can be performed together with other postbariatric procedures.

Face lift with U threads

The main and more frequent problem in face lift is recurrence of platysma bands, and of skin excess at the bitterness and naso-jugal folds. To improve face lift stability, a new aging analysis is proposed. The visible sign of face aging is skin excess. SMAS retraction is a much less visible sign. Nevertheless, botulinum toxin injections elongate muscles of the SMAS and rejuvenate the face. In the Face Recurve Concept, MRI studies prove the mimic muscles retraction that comes with aging. Face lift techniques that are used today include SMAS plication, traction or excision, which increases discrepancy between the envelop, the skin and the core, the SMAS. As skin excision is poorly efficient because performed posteriorly, far from the anterior skin excess located at the medial neck or at the bitterness fold, the association to SMAS retraction exacerbates the gradient difference between envelop and core. This analysis shows first of all that it is paramount to preserve the SMAS. Secondly, that the sub-skin dissection has to be executed moving beyond the paramedian folds. Then permanent tensor threads anchored in the malar, parotid and mastoid aponeurosis with a U pass flatten the folds and reposition sub cutaneous tissue excess backward to the SMAS. No action is performed on the SMAS, only an horizontal section of the platysma at the hyoid level will avoid platysma band recurrence. Botulinum toxin injections performed just after block muscle regeneration. 35 patients have been operated on a one year period. Results are a lot more stable and swelling is lowered down to the minimum.

The uses of botulinum toxin A in facial aesthetics

The demand for non-surgical facial rejuvenation procedures is rising, and they are more popular than ever, with the aesthetic uses of botulinum toxin dramatically changing the landscape of facial rejuvenation. Botulinum toxin is a neurotoxin that works within cholinergic synapses present at neuromuscular endplates, preventing the transmission of neurotransmitters, such as acetylcholine, from nerves to muscles. This interference with nerve impulses leads to the muscles being temporarily weakened (paralysis). Botulinum toxin A was approved by the US Food and Drug Administration (FDA) for use in the glabella in 2002, followed by crow's feet in 2013 and then the forehead in 2017, with other aesthetic uses being classed as off-license. Botulinum toxin A yields good results in carefully selected patients, and a thorough consultation should always take place. Consultations should include management of expectations and the explanation that botulinum toxin A works on dynamic lines, rather than static lines. Treatment areas can be split into the upper face (glabellar, transverse forehead lines and lateral orbicularis oculi); mid face (bunny lines and perioral vertical lip lines); and lower face (masseter hypertrophy, mentalis, platysmal bands and gummy smile). Each patient should be assessed individually to determine individual anatomy, including the size, strength and location of muscles, with doses being adjusted accordingly.

Are routine post drain removal chest X-rays necessary after oesophagectomy?

&lt;p class="abstract"&gt;The aging effect of the neck is characterized by loss of elasticity and contractility of the skin. This aging is manifested clinically by the projection of the platysma bands, the redundancy of the skin, the accumulation of fat in the sub-mental, sub-mandibular regions, and the loss of the cervical-mental angle. Besides of face-lifting, there are other techniques for solving the aesthetic problems of platysma bands. This report aims to present our technique of the simple management of the platysma bands. We report our experience with the correction of platysma bands. The procedure is performed under local anaesthesia. The incision involves the skin and subcutaneous tissue; going from the lateral to the medial edge of the platysma band without cutting the muscle. The dissection of the muscle is continued to the deep side of the bands. This dissection is meticulous to preserve the superficial facial anastomotic plexus and the branch of the transverse cervical nerve afterward the muscle is cut. The technique mainly concerns individuals between the 4th and 6th decades. Women appear to be more concerned about the aesthetic appearance of their neck than men are. This technique is a simple surgical method, and in the majority of the cases, the results are satisfactory. It can be used alone or combined with face lifting. The technique of aesthetic treatment of platysma bands is a simple, effective surgical procedure and in most cases, the results are satisfactory.&lt;/p&gt;

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.

Does the Approach of the Lateral Platysmal Bands Widen the Gap between the Medial Bands?

Background:The first visible change in an aging face and neck is the loss of neck contour, which can be corrected by treating the platysmal bands; however, it remains unclear as to which is the best strategy to approach these bands. The aim of the present study is to verify whether the lateral platysmal bands approaches, before the medial ones, cause widening of the gap between them.Methods:This is a prospective, randomized, comparative study involving 30 individuals presenting various stages of neck and facial flaccidity and sagging. The patients were split into 2 groups according to the lateral platysmal approach (group A: lateral platysmal traction/plication; group B: lateral platysmal undermined/traction). A protocol was established to measure the gap between the medial bands, 3 and 5 cm away from the chin, before and after superficial musculoaponeurotic system/platysma lateral suspension. Measurements were taken using a compass and a ruler. The endpoint was to determine whether the gap between the medial platysmal bands widens after the lateral procedure.Results:Group A, first measure (1-M): the gap ranged between 1.0 and 1.6 cm in point M3 (3 cm away from chin) and between 1.8 and 3.0 cm in point M5 (5 cm away from chin) (mean in M3 = 1.2; SD, 0.22 and mean in M5 =2.3; SD, 0.52). Group A, second measure (2-M): the measure ranged between 1.0 and 1.7 cm in point M3 and between 1.8 and 3.2 cm in point M5 (mean = 1.28; SD, 0.25 and mean = 2.42; SD, 0.63, respectively). Group B, first measure (1-M): the gap ranged between 1.1 and 1.7 cm in M3 (mean = 1.32; SD, 0.21) and between 1.8 and 3.2 cm in M5 (mean = 2.38; SD, 0.57). Group B, second measure (2-M): the measure ranged between 1.2 and 1.7 cm in M3 (mean = 1.4; SD, 0.18) and between 2.0 and 3.2 cm in M5 (mean = 2.5; SD, 0.55). Group A: P = 0.07 (M3) and 0.10 (M5); Group B: P = 0.09 (M3) and 0.07 (M5).Conclusion:The lateral platysmal approach, plication or undermined, does not lead to a widening of the gap between the medial platysmal bands.

Effective Treatment of Platysma Bands with Neurotoxin.

Effective Treatment of Platysma Bands with Neurotoxin.