title: Submental muscular medialization and suspension.
abstract: BACKGROUND
  Many techniques have been presented over recent decades to address the neck contour in facial rejuvenation surgery. Despite advances, limitations remain when dealing with the obtuse cervical angle.
  
  
  OBJECTIVE
  The authors describe a technique for improving the obtuse cervicomental angle.
  
  
  METHODS
  The authors reviewed the charts of 295 patients who underwent the authors' submental muscular medialization and suspension (SMMS) technique to improve their neck contour, either alone or in combination with a facelift, between January 1, 2001, and December 30, 2003. The technique medializes and suspends the medial free edges of the platysma muscle and, when anatomy dictates, the anterior bellies of the digastric muscle to the deeper mylohyoid muscle.
  
  
  RESULTS
  Eighty-seven (30.5%) of the 285 facelift patients examined underwent SMMS, and 10 additional patients underwent isolated SMMS. No patient required reoperation for hemostasis or evacuation. Three (1.05%) of the facelift with SMMS patients required reoperation for dehiscence of the submental suspension. None of the isolated SMMS patients had muscular suspension dehiscence or required reoperation. Seven (2.4%) patients (5 with SMMS and 2 without SMMS) with excessive facial and cervical tissue preoperatively developed a small amount of postoperative submental skin redundancy and subsequently underwent submental skin excision at 1 year postoperatively.
  
  
  CONCLUSIONS
  Submental muscular medialization and suspension is a simple yet highly effective surgical technique that can result in dramatic and enduring improvement in the cervicomental angle.
authors.affiliation: Dr Langsdon is a Professor at the University of Tennessee Health Science Center and Chief of the Division of Facial Plastic Surgery in the Department of Otolaryngology-Head & Neck Surgery, University of Tennessee Health Science Center, Germantown, Tennessee, where Dr Velargo and Dr Rodwell are residents.
authors.forename: Phillip R
authors.initials: PR
authors.lastname: Langsdon
authors.forename: Parker A
authors.initials: PA
authors.lastname: Velargo
authors.forename: David W
authors.initials: DW
authors.lastname: Rodwell
authors.forename: Douglas
authors.initials: D
authors.lastname: Denys
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000601:surgery*; D012060:Rejuvenation; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D016896:Treatment Outcome
keywords: aging face; aging neck; cervicomental angle; platysmaplasty; rhytidectomy