A new approach to functional anatomy of the lower face: Role of the hyoplatysmal ligament, of the platysma and of the depressor labii lateralis

Annales de chirurgie plastique et esthétique
Claude Le Louarn

Abstract

Although there are numerous techniques for necklift, medium-term instability is frequent with this procedure. A misunderstanding of the functional anatomy of the neck may explain these unsatisfactory surgical outcomes. The author analyzes the functional anatomy of the platysma (PLA) and of the hyoplatysma ligament. The depressor labii lateralis (DLL) is described for the first time. The PLA was dissected in 4 fresh adult cadavers to infer its function and to reevaluate current knowledge regarding this anatomic region. In addition, 30 patients who presented to the author's private practice for rejuvenation of the lower face were photographed undergoing specific muscle contractions for functional analysis. The PLA functions as a neck elevator only. Lower lip traction is controlled by independent antagonistic muscles, including the depressor labii inferioris, the anguli oris, and the DLL. The juxtaposition of these antagonistic muscles occurs at the mandibular line, which explains why the aging process is so distinct in this area. The hyoplatysmal ligament is responsible for the creation and stability of the acute cervicomandibular angle. The aim of neck rejuvenation should be to restore elongation of the PLA posteriorly and to cr...Continue Reading

References

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Citations

Dec 28, 2016·The Journal of Craniofacial Surgery·Kun HwangJae Hyun Lim
Apr 27, 2017·Journal of Physics. Condensed Matter : an Institute of Physics Journal·Zhaoguo LiWeidong Wu
Nov 4, 2017·Journal of Anatomy·Astrid MayChristian Albrecht May
Oct 22, 2019·The Journal of Craniofacial Surgery·Jung Ho ChoiHun Kim
Oct 9, 2019·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Meihua GongDaping Yang
May 14, 2020·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Daqi ZhangHoon Yub Kim
Jan 23, 2021·Aesthetic Plastic Surgery·Darryl Hodgkinson

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