The Anatomical Basis for Common Cosmetic Anterior Neck Deformities

Sherman, Gary M.; Souther,; Vistnes, Lars M.

doi:10.1097/00000637-197905000-00004

Cited by 66 publications

(24 citation statements)

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“…1,6 This contention results from the anatomically tenuous relationship of the gland with several vital neurovascular structures within the submandibular triangle, and the consequent potential risk for loss of function and salivary fistula posed by surgery. 6 The submandibular gland, which is the second largest of all salivary glands, is a U-shaped structure that envelops the posterior border of the mylohyoid muscle, with superficial ramifications penetrating into the sublingual spaces.…”

Section: Discussionmentioning

confidence: 99%

“…Excessive folds of flaccid skin, selective fat deposition, platysmal banding, prominent anterior belly of the digastric muscle, bone resorption, and ptotic submandibular glands all conspire against the graceful contours of the youthful neck in an aesthetically deforming metamorphosis. [1][2][3] Although successful treatments have been described for the majority of these morphologic changes, correction of the ptotic submandibular gland remains a challenging surgical problem. Portending a jowly submandibular fullness, a fallen gland is seemingly intractable because of the inherent risks in manipulating the gland's delicate stroma, and surgically navigating the submandibular triangle, the gland's inhospitable home.…”

mentioning

confidence: 99%

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Basket Submandibular Gland Suspension

Guyuron¹,

Jackowe²,

Iamphongsai³

2008

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Basket Submandibular Gland Suspension

Guyuron¹,

Jackowe²,

Iamphongsai³

2008

Plastic and Reconstructive Surgery

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“…The platysma muscle is invested on both sides by the superficial cervical fascia. 2 Innervation is from the cervical branch of the facial nerve, and the action is to lower the lateral canthus of the lower lip. 3 The platysma also covers and protects the sternocleidomastoid muscle, the marginal mandibular branch of the facial nerve, the sensory nerves to the face, the facial artery and vein, the submandibular gland, and the lower part of the parotid gland.…”

Section: Anatomymentioning

confidence: 99%

“…The age-related anatomic factors that contribute to this condition are (1) cutaneous flaccidity, (2) submental and submandibular fat deposits, (3) flaccidity or rigidity of the platysma muscle in the anterior or posteriolateral portions, and (4) submandibular gland ptosis or hypertrophy. 1 Surgical therapies must be guided by an appreciation for these mechanisms.…”

mentioning

confidence: 99%

Contralateral Platysma Suspension

Henley

Lesnik

Terk

2005

Archives of Facial Plastic Surgery

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“…In 15%, the fascicles come together at the level of the thyroid cartilage, like a single muscle in the suprahyoid region. In the remaining 10%, the fibers are separate, but inserted into the subcutaneous muscles of the chin without decussation [17,18].…”

Section: Introductionmentioning

confidence: 99%

Yes to a tight neck, no to a rhytidectomy

2002

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Many patients emphatically refuse a face lift to improve the shape of the cervico-mandibular angle, but are nevertheless not prepared to put up with ugly skin folds and the platysma bands. As an alternative we can offer a platysmaplasty in combination with a submental skin excision, often used with liposuction in the chin and cheek area. From December 1995 to April 1999, 20 patients between the ages of 33 and 82 (mean age 57), 12 female and eight male were operated on using a submental incision. A cervical skin flap with a thin layer of fat was raised. It was taken down to the larynx and its length was 4-5 cm. Most of the fat was taken off the platysma muscle up to the external jugular vein, where this crosses the sternocleidomastoid muscle. The platysma edges were raised and joined in the midline, using a running suture. Any excess skin was excised in a spindle-shaped fashion. In 14 cases additional liposuction above the mandible was necessary. In three cases no platysma tightening was indicated, and on 3 occasions a midline skin excess was excised incorporating a Z-plasty. In summary, the operations are performed under local anesthesia and therefore do not cause the patient too much stress. If necessary, subplatysmal fat can also be removed in the same operation. The median platysma muscle edges are approximated in the midline starting at the mandibular symphysis, and this is continued at least down to the middle of the neck above the larynx. In female patients the approximation is done above that level to avoid the prominence of the larynx. A small horizontal incision below the suture line will eliminate the bowstring effect. A platysma duplication above the submandibular gland can make it less obvious.

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The Anatomical Basis for Common Cosmetic Anterior Neck Deformities

Cited by 66 publications

References 0 publications

Basket Submandibular Gland Suspension

Basket Submandibular Gland Suspension

Contralateral Platysma Suspension

Yes to a tight neck, no to a rhytidectomy

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