Techniques and concepts for treatment of the aging neck have been evolving since the
late 1960s and rely on two-dimensional anterior approximation with lateral imbrication
of the platysma with or without submental fat reduction, However, the medial approximation
can sometimes give a “boxy” appearance to the anterior neck, especially if anterior
shifting of the platysma recurs after platysmaplasty with laxity redeveloping in this
midline location. The “purse-string” platysmaplasty (PSP) is a new concept in neck
contouring that facilitates an enhanced definition for the cervicomandibular transition
to better simulate the well-defined contour of this transition that is present in
youth. It aids in the contouring of difficult poorly defined necks and in male patients.
The PSP adds a “third dimension” to neck recontouring by invaginating the platysma
with a plication suture and pexing the platysma, without incising it, to deeper neck
fascia with a technique that adds support and definition to the neck contour. The
PSP can be performed in patients undergoing a full rhytidectomy as well as in individuals
having isolated neck rejuvenation. The PSP is especially helpful in rejuvenating the
male lower face and neck because of the relatively heavier deeper structures of the
male neck and the need to enhance definition along the jawline.
Neck rejuvenation - platysmaplasty - purse-string-platysmaplasty - rhytidectomy -
subperiosteal deep plane rhytidectomy - aging neck - platysmal banding - ePTFE suture
- suspension suture - ePTFE sling - superficial musculoaponeurotic system - SMAS -
corset platysmaplasty - liposuction - hammock platysmaplasty
