### Ultrasound Diagnostics in Aesthetic Surgery of the Face and Neck
Therefore, it is enough to only influence the fatty tissue along its contour to correct the contours of the lower jaw in this clinical case according to the results of ultrasound examination. When comparing the results of the ultrasound examination of the soft tissues of the lower third of the face and neck in male (\(n\) = 14) and female (\(n\) = 73) patients, we noted that in males, involutive changes in platysma were observed at an older age than in women. It was noted that the platysma muscle itself in males (1.7 \(\pm\) 0.3 mm) was thicker (0.35 \(\pm\) 0.8 mm (\(\pm\)SE standard deviation average)) than in females, and denser (Figures 4 and 5), which has a beneficial effect on its tone and prevents early ptosis of these tissues. Intraoperative ultrasound plays an invaluable role in a number of clinical situations in minimally invasive facial and neck rejuvenation surgeries when there are practically no skin incisions and direct visualization of the intervention area is impossible. _Clinical case_ #6. When conducting the study intraoperatively, a 53-year-old patient with a 9 MHz linear transducer of the soft tissues of the lower third of the face and neck without pressure exhibited strands of platysma muscle (Figure 6a). During an objective examination, due to excessive accumulation of adipose tissue in the submental area and along the contour of the lower jaw bilaterally, the presence of platysma strands was not determined. After liposuction of the above areas, a closed platysmotomy was performed under the palpatory control. During intraoperative ultrasonic control (Figure 6b), it was determined that the platysma string, which deformed the neck-submandibular angle, was not completely incised. Under the control of ultrasound, additional incisions of the platysma muscle (Figure 6c) were performed to obtain a good clinical result. In this clinical case, the importance of the role of intraoperative ultrasound in aesthetic surgery of the face and neck for the prevention of additional interventions and obtainment of good and predictable results was confirmed. No other method can achieve this currently, especially intraoperatively. The results of the ultrasound studies determined the useful possibilities, informativeness, and practical significance of this type of research when planning methods of correction in aesthetic surgery of the face and neck. It is noted that linear transducers from 9 MHz to 20 MHz are sufficient for the visualization of soft tissues of the cervical-facial region, since the required penetration depth is on average from 0.5 cm to 4 cm. Accordingly, ultrahigh-frequency ultrasound is less appropriate for practical use in plastic surgery since it does not always have a sufficient research depth for a full assessment of age-related changes in the soft tissues of the head and neck. Additionally, during the study, it was concluded that a standardized ultrasound protocol is needed to visualize the soft tissues of the cervical-facial region. An ultrasound specialist should be able to examine and determine the morphology and topography of the soft tissues of the face and neck, and conduct a qualitative and quantitative assessment of the soft tissues of the cervical-facial region  
Figure 6: B-mode ultrasound examination of soft tissues of the face and neck with a 9 MHz linear transducer. The severity of platysma. Excessive accumulation of adipose tissue along the contour of the lower jaw (**a**). Intraoperative visualization, wrong incomplete section of the platysma muscle strand (**b**). Control ultrasound, complete cutting of the strand (**c**). by measuring the muscles, thickness of subcutaneous fat, and skin. Key elements of the ultrasound examination for effective and reliable identification of age-related changes in the soft tissues of the face and neck are as follows: the patient's vertical position during the study; B-mode; linear transducer (optimal 9-20 MHz).