A standard corset platysmaplasty may be performed if significant platysma banding exists or if there is added need for neck definition. A corset platysmaplasty involves removal of the redundant medial platysma from the mentum to the level of the hyoid bone. Removal of midline submental fat often is included with the muscle resection. The fresh edges of the platysma then are reapproximated in the midline using buried nonabsorbable sutures to tighten the platysma sling in the neck in a fashion similar to the tightening of the laces on a corset. The periauricular incisions are made, and the skin is elevated in a subcutaneous plane.
Great care is taken to avoid injury to the great auricular nerve in the neck.
A small amount of subcutaneous fat is left on the skin flap to avoid excessive thinning of the flap. The dissection proceeds above the platysma to connect with the previous submental dissection in the neck. The subcutaneous dissection in the face proceeds to a line drawn from the angle of the mandible to the level of the origin of the zygomaticus major and minor muscles. An incision is made in the SMAS layer that parallels this line. The SMAS is elevated gently, and the dissection proceeds from inferior to superior and lateral to medial.