The case for full-width platysma transection and rotation

The long-term evaluation of results in 209 neck rhytidoplasties is presented, comparing different surgical techniques. The results of skin-tightening neck lifts, partial platysma severing, and SMAS plicature procedures in 74 cases (35.4%) are analyzed. Under the same parameters, the results obtained in another comparative group of 135 patients (64.6%) in which a full-width platysma transection and rotation were carried out between 1980 and 1995 by the main author of this paper. The postoperative evaluation after five to 20 years (average 8.6 years) in 140 cases (66.98%) of the 209 cervical rhytidoplasties is reported. The argument in favor of the full-width platysma transection and rotation is focused on the vertical neck bands and the neck angularity deterioration, its etiology and anatomic and physiologic facts that support the indications of this technique. These considerations also explain the poor results obtained when other procedures are used to deal with the vertical neck bands and cervical angularity deterioration, when the purpose is a durable correction of these anomalies.