Platysmaplasty

Platysmaplasty is a group of approaches to reposition and support the platysma muscle based on what the neck actually needs. In practice, surgeons choose (or combine) techniques depending on banding, laxity, and deeper anatomy. Platysmaplasty techniques include medial (corset) repair, lateral suspension, and combined approaches, often supplemented by subplatysmal procedures depending on the underlying anatomical contributors to neck aging. • medial platysmaplasty (corset technique) is performed through a submental incision under the chin. The medial borders of the platysma are brought together in the midline to reduce platysmal banding and restore central neck support. StatPearls describes anterior or medial platysmaplasty as midline approximation of platysmal diastasis from the chin toward the thyroid cartilage. • lateral platysmaplasty / platysmapexy, often described as lateral platysmapexy or lateral suspension, supports the platysma laterally rather than repairing the central muscle edges under the chin. StatPearls describes lateral platysmapexy as suturing the platysma to the upper quarter of the sternocleidomastoid fascia, while Labbé’s PubMed-indexed article describes suspending the free edge of the platysma and fixing it to resistant tissue near the earlobe. • subplatysmal / deep neck techniques are not platysmaplasty alone, but they are often performed with platysmaplasty when deeper structures contribute to fullness. These may include subplatysmal fat, anterior digastric muscle, and submandibular gland management. Auersvald’s article on submandibular gland management states that common neck concerns include hypertrophy of subplatysmal fat, the anterior belly of the digastric muscle, and/or the submandibular salivary glands. • layered / comprehensive neck lift approach evaluates the skin, fat, platysma, and deeper structures rather than treating the neck as a surface problem. Current review literature describes neck management in three key areas: anterior platysma, subplatysmal structures, and lateral neck support. == Incision closure ==

Closure after a platysmaplasty is performed using a layered, tension-free technique designed to preserve the underlying structural repair. Following approximation or suspension of the platysma muscle, the subcutaneous tissues are reapproximated to reduce dead space, and the skin is redraped and closed without tension to optimize scar quality and contour. Modern neck lift literature emphasizes that platysma manipulation, including midline plication or lateral suspension, provides the primary structural support, while skin closure serves a secondary, non–load-bearing role. == See also ==