The case for full-width platysma transection and rotation

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Facial Anatomy

Background:

• Neck aging involves vertical bands and loss of angularity.
• Various surgical techniques aim to address these concerns.
• Long-term outcomes of different neck lift procedures require evaluation.

Purpose of the Study:

• To compare the long-term efficacy of different surgical techniques for cervical rhytidoplasty.
• To evaluate outcomes of skin-tightening, partial platysma severing, and SMAS plicature versus full-width platysma transection and rotation.
• To identify the optimal technique for durable correction of vertical neck bands and neck angularity.

Main Methods:

• Long-term retrospective analysis of 209 neck rhytidoplasties.
• Comparison of outcomes between skin-tightening/partial platysma/SMAS plicature (74 cases) and full-width platysma transection/rotation (135 cases).
• Postoperative evaluation of 140 cases (average 8.6 years follow-up, ranging 5-20 years).

Main Results:

• Full-width platysma transection and rotation demonstrated superior results in addressing vertical neck bands and neck angularity.
• Other techniques, including partial platysma severing and SMAS plicature, showed poorer long-term outcomes for these specific concerns.
• The study highlights the anatomical and physiological basis for the effectiveness of the full-width technique.

Conclusions:

• Full-width platysma transection and rotation is the preferred technique for durable correction of vertical neck bands and neck angularity.
• Understanding the etiology of neck aging anomalies supports the indication for specific surgical approaches.
• Techniques other than full-width platysma transection and rotation are less effective for long-term correction of these aging features.