ABSTRACT
Three-dimensional implants of beaded polyethylene are tailored to the areas of deficit. This restores bone volume and provides adequate support for the soft tissues. The deep layer cervicoplasty involves removing fat from the subplatysmal plane and from between the anterior bellies of the digastric muscles. The anterior bellies of the digastric muscles are sutured together. The platysma muscle is separated from the underlying submandibular gland so that the gland will not be pulled anteriorly with the muscle. Suspension of the fascia with sutures and imbrication of the overlying platysma muscle elevates the submandibular gland. A short corset platysmaplasty is performed. The digastric muscles are included in the sutures. Most patients benefit from a cervical suspension suture to give a crisp break between the neck and the floor of the mouth. In those with young, elastic skin there may be no need to perform skin resection. Patients with poor skin quality or excessive skin on the neck and jaw line will require an excisional cervicoplasty. This may be done with the addition of a high retroauricular incision. To tighten the skin of the lower face concurrently, the
incision is extended around the lobe and up to the base of the helix (i.e. cervicofacial rhytidectomy).
