The platysma has tendinous origins from the superficial pectoral and deltoid fascia and tendinous insertions into the mandibular border, the lower facial skin, and the modiolus at the angle of the mouth. Its fibrous bands are responsible for the anterior neck banding seen with ageing and muscular contraction.
Platysma banding in the anterior neck is a primary target in neck rejuvenation surgery. Platysmaplasty involves midline plication and lateral suspension of the platysma bands. Botulinum toxin injection into the platysma reduces neck banding and is used in the Nefertiti lift technique. The tendinous insertions at the mandible are divided in submental liposuction approaches to allow adequate undermining.
Fibrotic thickening of the platysma tendinous bands producing visible anterior neck cords, treated with botulinum toxin injection or surgical platysmaplasty depending on severity.
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