Abstract
Restoration of the esthetic neck contour is an integral component of facial rejuvenation. Characters of the aging neck include lipodystrophy, platysmal bands and jowls that extend into the neck, reducing the esthetic characters of the lower face. The authors present a new, simplified and economic method to manage platysmal bands as an office procedure under local anesthesia using a standard 18-gauge syringe needle as a cutting tool. The new technique was used on a selected group of female patients classified as non-surgical cases according to Rorich classification. Twenty-five female patients shared in this study, with a follow-up period standardized to 1 year; one patient showed up after 1.5 years with preserved esthetic outcome. One patient showed residual band managed by recutting immediately after bruising and edema resolved. The technique was proven safe regarding important neurovascular structures of the neck. Patients gave no negative comments regarding results of surgery. Kappa statistical analysis showed perfect interobserver agreement between patients and an independent assessor. The authors concluded that the studied new technique is safe, effective, and valuable for management of platysmal bands in a selected group of patients.
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References
Rohrich RJ, RiosJL Smith PD, Gutowski KA (2006) Neck rejuvenation revisited. PlastReconstrSurg 118(5):1251–1263
Watson D (2005) Submentoplasty. Facial PlastSurgClin North Am 13(3):459–467
Dayan SH, Benjamin B, Rayan MG, Amit BP (2009) Ch.6: Neck rejuvenation. In: Hirsch R, Sadick N, Cohen JL (eds) Aesthetic rejuvenation a regional approach. McGraw Hill Medical, pp 123–149
De Maio M, Rzany B (2007) Chap. 5: The most common indications. In: De Maio M, Rzany B (eds) Botulinum toxin in aesthetic medicine. Springer Verlag, Berlin Heidelberg, pp 27–92
Sulamanidze MA, Salti G, Mascetti M, Sulamanidze GM (2000) Wire scalpel for surgical correction of soft tissue contour defects by subcutaneous dissection. DermatolSurg 26(2):146–150
Saylan Z (2001) Serial notching of the platysmal bands. AesthetSurg J 21(5):412–417
Daher C (2011) Closed platysmotomy: a new procedure for the treatment of platysma bands without skin dissection. Aesthetic PlastSurg 35(5):866–877
Gonzalez R (2013) Closed platysmotomy: a new procedure to treat platysmal bands. Aesthetic PlastSurg 37(3):636–637
De Castro CC (1980) The anatomy of the platysma muscle. PlastReconstrSurg 5:680–683
Vistnes LM, Souther SG (1983) The platysma muscle: anatomic considerations for aesthetic surgery of the anterior neck. Clin Plast Surg 10(3):441–448
Davies JC, Agur AMR, Fattah AY (2013) Anatomic landmarks for localization of the branches of the facial nerve. OA Anatomy 1(4):33
Owsley JQ, Argwal CA (2008) Safely navigating around facial nerve in three dimensions. Clin Plast Surg 35(4):467–477
Roostaeian J, Rohrich RM, Stuzin JM (2015) Anatomical considerations to prevent facial nerve injury. Plast Reconstr Surg 135(5):1318–1327
Ozturk CN, Ozturk C, Huettner F, Drake RL, Zins JE (2014) A fail safe method to avoid injury to the great auricular nerve. Aesthet Surg J 34(1):16–21
Lefkowitz T, Hazani R, Chowdhry S, Elston J, Yaremchuk MJ, Wilhelmi BJ (2013) Anatomical landmarks to avoid injury to the great auricular nerve during rhytidectomy. Aesthet Surg J 33(1):19–23
Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360–363
Fogli AL (2008) Skin and platysma muscle anchoring. Aesthetic Plast Surg 32(3):531–541
Guyron B, Sadek EY, Ahmadian R (2010) A 26-Year experience with vest-over-pants technique platysmarrhaphy. Plast Reconstr Surg 126(3):1027–1034
Fledman JJ (2014) Neck lift my way: an update. Plast Reconstr Surg 134(6):1173–1183
Acknowledgements
The authors would like to acknowledge the efforts of professor Dr. Ashraf Abdel Kader Ahmed Aly (plastic and Reconstructive Surgery Department, Al Azhar University, Cairo, Egypt) for giving his valuable objective opinion in the assessment of the results of this work.
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The authors have no conflicts of interest to disclose. There were no conflict of interests of any kind stated by the International Committee of Medical Journal Editors Regulations.
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All the procedures performed in this study that involved human participants were in accordance of the institutional, national research committee and compliant with the 1964 Declaration of Helsinki and its later amendments and comparable ethical standards. Informed consent was obtained from all individual participants in this study including scientific publications of their clinical photography, videos, etc.
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Hegazy, A.M., Farouk, M. A Simplified Method for Management of Platysmal Bands: Platysmotomy as an Office Procedure. Aesth Plast Surg 41, 1351–1359 (2017). https://doi.org/10.1007/s00266-017-0934-8
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DOI: https://doi.org/10.1007/s00266-017-0934-8