Cervical contouring in face lift

James M. Stuzin, MDJoel J. Feldman, MDDaniel C. Baker, MDTimothy J. Marten, MDDr. Stuzin: The first patient is a 45-year-old woman who is concerned about the solitary platys-ma band in the right side of her neck (Figure 1). Dr. Baker, how would you approach treating this patient?Dr. Baker: I see very few options. She has overtreated skin, minimal facial aging, and very little neck fat. I would avoid operating on her.Dr. Stuzin: Dr. Feldman, how would you evaluate this patient?Dr. Feldman: Her neck looks good except for that short platysmal band that bothers her, but she also appears to have an enlarged right submandibular salivary gland. I would free the medial edges of the platysma from the superficial fascia, undermine the muscle to the anterior gland capsule, open the capsule, and, using the electro-cautery, take out just enough of the superficial lobe to flatten the bulge. It appears that there is no need to remove subplatysmal fat. I would repair the platysma with a full corset platysmaplasty to cover the entire anterior neck with a smooth sheet of muscle and, of course, eliminate the muscle band. I would undermine the neck skin flap widely enough to redistribute the skin so that none of it would need to be removed.Dr. Stuzin: Do you believe you could do that effectively and safely through a submental incision?Dr. Feldman: Yes, I would use only the submental incision.Dr. Stuzin: Dr. Marten, how would you approach treatment?Dr. Marten: This patient has a severe, unnatural look and overtreated skin. Her eyebrows are shaved and penciled in higher, hiding her forehead pto-sis. She has lower lid retraction, midface laxity, and scant submental fat, which suggests she has had prior submental lipoplasty. I agree that she has a …