Discussion. Modified deep plane rhytidectomy with a lateral approach to the neck: an alternative to submental incision and dissection.

摘要

Although much of the recent controversy in face lifting has centered on methods of repositioning midface fat through various superficial musculoaponeurotic system (SMAS) techniques, the evolution of the modern face lift actually began with an investigation of methodologies to improve cervical contour. As early as 1955, Davis is credited with advocating excision of submental fat in rhytidectomy, and the work by Adamson et al. in combining direct cervical skin excision with platys-maplasty launched modem efforts to improve cervical contour in rhytidectomy. Millard was the first to advocate the use of the submental incision to perform both submental and submandibular lipec-tomy, and as the submental incision became widely used, surgeons such as Guerro-Santos et al. and Connell routinely performed anterior platysma plication in conjunction with lateral platysma redrap-ing in their face-lifting techniques. After their pioneering work, numerous platysmaplasty techniques appeared in the literature, with the work of Feldman in the early 1990s perhaps serving as a definitive reference to the effect of anterior platysma plication on cervical contour.