Surgical Denervation of Platysma Bands: A Novel Technique in Rhytidectomy

Abstract

Prominent platysma bands in the neck are one of the first signs of aging. There is increasing demand for surgical facial rejuvenation, including procedures to tighten skin and muscle in the neck; however, obtaining long-lasting results is a challenge. The aim of this study was to characterize the efficacy and safety of platysma muscle denervation for this indication. The authors performed surgical platysma denervation, involving selective cervical branch section simultaneously performed with rhytidectomy, in eight patients with unilateral facial paralysis (as a solution for visible platysma bands on the unaffected side of the face) and in one patient requiring aesthetic rhytidectomy (bilateral surgery). Patients were monitored for at least 3 months after surgery (in some cases, for up to 21 months). There were no major postoperative complications. Eight of the patients were unable to contract the platysma following surgery, leading to an improvement in the platysma band appearance. This study demonstrated the effectiveness and safety of the platysma denervation technique. Sectioning the cervical branch of the facial nerve provides a permanent solution to improve the cosmetic appearance of platysma bands and can be combined with rhytidectomy. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.