9802-473 Knize
Knize DM.
Limited incision submental lipectomy and platysmaplasty.
Plast Reconstr Surg. 1998 Feb;101(2):473-81. PMID: 9462784
Comment in:
Plast Reconstr Surg. 2004 Apr 1;113(4):1275-8.
Department of Surgery at the University of Colorado Health Sciences Center,
Denver, USA.
Thirty years ago, submental fat deposition and platysma band formation were
inadequately addressed by surgeons attempting facial rejuvenation procedures.
Simple skin envelope tightening as practiced commonly at that time resulted in
reappearance of submental bands within months, disappointing both patient and
surgeon. During each subsequent decade, existing techniques for aesthetic
surgical treatment of the submental and neck areas were refined, and new
techniques were introduced. The earliest in this evolution of surgical
approaches to rejuvenate the aging submental region was direct excision of
redundant anterior cervical skin and platysma muscle bands. Later, periauricular
incision approaches without anterior skin excision were used to address platysma
muscle bands and remove excess submental fat. Today, the standard approach for
submental and anterior neck rejuvenation is some variation of "corset"
platysmaplasty and suction-assisted lipectomy both superficial and deep to the
platysma muscles. The introduction of endoscopy to plastic surgery has
stimulated interest in performing many surgical procedures through
limited-incision approaches. While endoscopic techniques may not have a clear
application for the submental area, redundant submental soft tissues producing
obliquity of the cervicomandibular angle may be treated through a single
submental incision approach under direct vision. A technique practiced by the
author since 1981 for performing submental lipectomy and platysmaplasty through
a single limited anterior submental incision without skin excision is described
and discussed. Postoperative compression of the submental area with an elastic
garment facilitates smooth skin contraction and redraping for all patients
except those with poor or no residual skin elasticity.
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