A novel approach for platysmaplasty using an intraoral, transmucosal approach.
Andrew Timberlake, MD, PHD, Karl Bruckman, MD, DDS, Derek Steinbacher, MD, DMD.
Yale University, New Haven, CT, USA.
Background: Platysmaplasty is a surgical procedure that augments the aesthetic benefits of necklift surgery provided by tightening of the platysma muscle. Numerous approaches exist to accomplish this, including medial and lateral approaches to the platysma. The traditional approach to midline platysmal plication requires creating a small transcutaneous, submental incision. Alloplastic or osseous genioplasty, as well as lipectomy, may be performed in conjunction with soft tissue neck rejuvenation to balance the face and further improve the cervicomental angle. Although these scars are well hidden, this incision is often of concern to patients seeking to minimize demonstrable signs of having undergone cosmetic surgery. Here, we propose a novel technique for approaching the medial platysma via an intraoral, transmucosal incision used concurrently for chin augmentation. Methods: Patients undergoing face- / necklift procedures with chin augmentation are described. All patients elected for osseous genioplasty and were approached via an intraoral incision. Morphometric measurements were taken, including chin - throat distance and cervicomental angle. Results: The midline platysmal plication was executed via the intraoral, transmucosal incision used to perform the osseous genioplasty, eliminating the need for a transcutaneous, submental incision. The aesthetic result was comparable to that of those undergoing lower face- / neck lifts with submental incisions. All patients demonstrated an increase in chin - throat distance, as well as a significant decrease in the cervicomental angle. All of the patients were extremely satisfied with the ability to obtain these results without the need for an additional incision.Conclusions: In patients undergoing osseous genioplasty in conjunction with face- / necklift procedures, midline platysmal plication was successfully performed via the same intraoral incision used for the genioplasty. This intraoral incision could also be used to perform the plastysmal plication in those not undergoing genioplasty concurrently with face- / necklift surgery. Excellent aesthetic results are possible in necklift surgery without a submental incision.
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