Hyoid Suspension of the Platysma: A Novel Technique for the Aging Neck
John Yousif, M.D.1, Hani Matloub, M.D.2, James Sanger, M.D.2.
1Columbia St Mary's Hospital System, Medical College of Wisconsin, Milwuakee, WI, USA, 2Medical College of Wisconsin, Milwaukee, WI, USA.
Beyond other issues such as lax skin, excessive fat or meaningful anatomic variation, in the majority of cases of facial rejuvenation, some type of manipulation of platysma is performed. Each method of platysmal management has a professed advantage as well as its potential shortcomings. The authors present a new method to contour the neck by stabilization of the anterior portion of the platysma to the hyoid fascia, creating a stable underlying foundation for the ideal, youthful cervical shape even in severe neck deformities.
We reviewed the charts of patients who had undergone hyoid suspension of the platysma as a part of neck contouring. The results were evaluated by patient satisfaction, and by clinician appraisal. Outcomes, complications and a detailed review of postoperative issues were documented. A comprehensive description of the operative technique and post-operative care is presented along with representative case reports, comparing and contrasting this techniques with other current methods.
Over the last 7 years 110 patients have had this technique, alone or in combination with facial rejuvenation. Patient follow up has been from 1-7 years with an average of 4 years. Three patients had post-operative hematomas, which were evacuated in the office. Two patients had a separation of the platysma away from the hyoid fascia requiring re-operation. Three patients had submental seromas, treated with office aspirations, 2 of whom later returned to surgery for scar revision. Patients were routinely very happy with their results. Outcomes were exceedingly consistent and long lasting. We have not seen and no patient has reported recurrence of anterior platysmal bands.
We are presenting a new technique to treat the aging neck by hyoid suspension of the platysma. This method provides reliable, reproducible, consistent, and long lasting results in all types of necks, from minimal distortion to significant deformity. This technique should be given strong consideration when addressing the aging neck.
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