Platysmaplasty: Is it Possible to Pull the Platysma Effectively in the Medial or Lateral Direction?

The aim of this study was to investigate whether it is possible to pull the platysma effectively in the medial or lateral direction (medial platysmaplasty and lateral platysmaplasty) and to explore the anatomical basis of those findings.Six hemifaces from 3 fresh cadavers were dissected. After skin removal, the platysma was pulled upward and in the medial or lateral direction with the ulnar side of the palm. Its mobility was checked. In 2 volunteers, using wooden bar, the skin overlying platysma was pulled in superomedial and superolateral direction.The platysma ran diagonally from the acromio-deltoid region to the perioral and submental area. In all hemifaces, the platysma was attached to the mandible along its course. The platysma inserted into the mandibular body. At its medial portion (approximately halfway medially from the mentum to the angle; 4-5 cm), the attachment was so firm that it could not be moved horizontally. The posterolateral portion of the platysma was indirectly attached to the mandible and movable. In cadaver, platysma did not move much when it was pulled in the medial direction. In the lateral direction, however, platysma did move well. In living body, when skin overlying platysma was pulled in superomedial direction and superolateral direction, 3 points marked on mandibular border moved about 1.5-2.0 cm and 2.0-2.5 cm respectively.It is thought that medial platysmaplasty can correct anterior neck deformities and redistribute neck skin mainly in the submental area, while that lateral platysmaplasty can pull the cheek skin in superolateral direction.