ABSTRACT
Some surgeons have proposed a transverse incision that fells nicely into skin creases in the anterior triangle of the neck. This is a reasonable approach; however, it entails a greater degree of difficulty to gain a high exposure, usually necessitating the use of an assistant pulling up rather heavily with army-navy retractors to expose the distal internal carotid artery (ICA) in a high case. It has been my experience that if the platysma is properly closed, there is no cosmetic difference between the vertical incision that I prefer and the transverse incision despite the fact that the latter more naturally follows the skin lines of the neck.
