The relationship of the great auricular nerve to the superficial musculoaponeurotic system

We reported in 1980 the course of the great auricular nerve from the perspective of the surgeon performing rhytidectomy using the platysma flap operation. Since the superficial musculoaponeurotic system (SMAS) operation has become increasingly popular during the interim, we reviewed the course of the nerve with regard to our current operative dissection. We found, in both clinical cases and anatomical specimens, that the great auricular nerve is deep enough to allow safe division of the SMAS along the anterior border of the sternocleidomastoid muscle.