Blending of the lateral deep slip of the platysma muscle into the buccinator muscle

The Distribution of the Nerves and Arteries of the Platysma for Clinical Applications

This study aimed to provide anatomical data on the platysma for clinical procedures. The authors obtained 25 specimens from 15 adult Korean cadavers (9 men, 6 women; mean age, 72 years; range, 61-85 years). Lines connecting the gonion with the gnathion (G-GN) and the acromial end (acromial end of the clavicle) with the sternal end (sternal end of the clavicle) were used as references. Modified Sihler staining was used to trace the nerves distributed in the platysma. The superior border values of the platysma were 12.1 ± 2.7 mm, 31.5 ± 5.3 mm, 42.4 ± 5.6 mm, and 61.7 ± 6.4 mm, respectively, for sections 2 through 5 on the G-GN line. The inferior border values of the platysma were 83.6 ± 19.1 mm, 80.1 ± 14.0 mm, 74.8 ± 14.5 mm, 67.2 ± 13.7 mm, and 54.6 ± 7.1 mm, respectively, for the 5 sections on the acromial end of the clavicle-sternal end of the clavicle line. In the hyoid bone, cricoid cartilage, and jugular notch, the mean distance between the bilateral platysma was 14.4 ± 2.2 mm, 22.6 ± 10.6 mm, and 51.1 ± 15.7 mm, respectively. The mean angle at the cervical branch of the facial nerve and the anterior border of the sternocleidomastoid muscle sternal head was 28.7 ± 2.6 degrees and 53.4 ± 7.7 degrees from the G-GN line, respectively. The upper third of the platysma was supplied by branches of the facial artery and submental artery. The middle third was supplied by branches of the occipital artery and received its direct blood supply from branches of the external carotid artery. The lower third was supplied by branches of the transverse cervical artery. The authors hope that the results of this study will be helpful for rejuvenation procedures of the neck.

Clinical Implications of the Extension of Platysmal Fibers on the Middle and Lower Face

BACKGROUND

Despite the area of insertion of the facial portion of the platysma being broad and highly variable, the details of its pattern of extension and morphology are not well described in the medical literature. The aim of this study was to clarify the extension patterns of the platysma on the middle and lower face by topographic examination and detailed dissection.

METHODS

A detailed dissection was performed in the cheek region of 34 cadaveric specimens. The anatomical aspects of the extent of the platysma were classified according to its area of coverage on the cheek.

RESULTS

The location of the posterior fibers of the platysma passing behind the mandibular angle were located 17.1 ± 8.8 mm (mean ± SD) from the mandibular angle. The platysma was classified into patterns (A, B-1, B-2, and C) according to its coverage area: in type A (8.8 percent), areas S1 to S2, M1 to M3, and I1 to I3 were partially covered by the platysma; in type B-1 (58.8 percent), areas M1 to M3 and I1 to I3 were partially covered; in type B-2 (26.5 percent), areas M1 to M2 and I1 to I3 were partially covered; and in type C (5.9 percent), areas I1 to I3 were partially covered.

CONCLUSION

The description of the extent of the facial portion of the platysma presented in this article provides detailed anatomical knowledge regarding the midface, and represents fundamentally important knowledge for surgeons conducting rhytidectomy and other facial operations.