Abstract
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.
Keywords
facelift - platysma - platysmaplasty - platysma suspension - jawline - platysma bands
