Continuing medical education examination-facial aesthetic surgery the hammock platysmaplasty

The reader is presumed to have a broad understanding of plastic surgical procedures and concepts. After studying this article, the participant should be able to: Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material covered in this article. In this article, I describe the pertinent anatomy of the neck, the characteristics that define a youthful-appearing neck, subsequent changes associated with the aging neckline, and the surgical procedure I am currently using for restoring the youthful appearance of the neck through a submental approach. This procedure consists of overlapping the platysma muscles (in "double-breasted" fashion) in the midline by use of lateral traction sutures anchored to the periosteum and deep fascia of the contralateral mastoid region. In cases of severe muscular laxity, the platysma muscles are partially sectioned horizontally at the level of the hyoid bone, creating four muscle flaps (extended procedure). This muscular sectioning functionally elongates the abnormally shortened medial edge of the muscles. The subsequent overlapping of these flaps permits deepening of the cervicomental angle. The surgical procedure is performed exclusively through a submental approach, and avoids the posterior traction of the platysma muscle. Its indications are described in detail. Furthermore, the indications and procedures for a supplemental cervical approach in those patients with skin redundancy are discussed. My experience with 43 consecutive patients is presented, with a follow-up of 2 years and 9 months.