Download PDF
CC BY-NC 4.0 · Arch Plast Surg 2016; 43(04): 374-378
DOI: 10.5999/aps.2016.43.4.374
Idea and Innovation

A Novel Approach to Submandibular Gland Ptosis: Creation of a Platysma Muscle and Hyoid Bone Cradle

Robert Lukavsky
Department of General Surgery, Temple University Hospital, Philadelphia, PA, USA
,
Gary Linkov
Department of Otolaryngology, Temple University Hospital, Philadelphia, PA, USA
,
Christopher Fundakowski
Department of Otolaryngology, Temple University Hospital, Philadelphia, PA, USA
Fox Chase Cancer Center, Philadelphia, PA, USA
› Author Affiliations
› Further Information
   Permissions and Reprints

Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers. A submental incision with sharp dissection was performed to raise a supraplatysmal flap. A subplatysmal plane was developed until the submandibular gland was identified. Sutures were used to pexy the platysma to the hyoid bone periosteum and deep cervical fascia, tightening the overlying muscle and in turn elevating the submandibular gland. Submandibular gland ptosis must be corrected in order to achieve exemplary aesthetic results. Our approach of creating a cradle with the platysma and hyoid bone avoids the potential complications of previously described sling procedures, while still maintaining the integrity of the gland and surrounding tissues.

Keywords

Rhytidoplasty - Subamandibular - Cosmetics


Publication History

Received: 12 November 2015

Accepted: 04 April 2016

Article published online:
20 April 2022

© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Ellenbogen R, Karlin JV. Visual criteria for success in restoring the youthful neck. Plast Reconstr Surg 1980; 66: 826-837
    CrossrefPubMedGoogle Scholar
  • 2 Sullivan PK, Freeman MB, Schmidt S. Contouring the aging neck with submandibular gland suspension. Aesthet Surg J 2006; 26: 465-471
    CrossrefPubMedGoogle Scholar
  • 3 Guyuron B, Jackowe D, Iamphongsai S. Basket submandibular gland suspension. Plast Reconstr Surg 2008; 122: 938-943
    CrossrefPubMedGoogle Scholar
  • 4 Singer DP, Sullivan PK. Submandibular gland I: an anatomic evaluation and surgical approach to submandibular gland resection for facial rejuvenation. Plast Reconstr Surg 2003; 112: 1150-1154
    CrossrefPubMedGoogle Scholar
  • 5 Skandalakis JE, Gray SW, Rowe Jr JS. Surgical anatomy of the submandibular triangle. Am Surg 1979; 45: 590-596
    Google Scholar
  • 6 Lee MK, Sepahdari A, Cohen M. Radiologic measurement of submandibular gland ptosis. Facial Plast Surg 2013; 29: 316-320
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 de Pina DP, Quinta WC. Aesthetic resection of the submandibular salivary gland. Plast Reconstr Surg 1991; 88: 779-787
    CrossrefPubMedGoogle Scholar
  • 8 Labbe D, Giot JP. Open neck contouring. Clin Plast Surg 2014; 41: 57-63
    CrossrefPubMedGoogle Scholar
  • 9 Batra AP, Mahajan A, Gupta K. Marginal mandibular branch of the facial nerve: an anatomical study. Indian J Plast Surg 2010; 43: 60-64
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Giampapa V, Bitzos I, Ramirez O. et al. Suture suspension platysmaplasty for neck rejuvenation revisited: technical fine points for improving outcomes. Aesthetic Plast Surg 2005; 29: 341-350
    CrossrefPubMedGoogle Scholar