title: The relationship of the marginal mandibular nerve to the mandibular osseocutaneous ligament and lesser ligaments of the lower face.
abstract: BACKGROUND
  An in-depth understanding of the nuances of facial anatomy is the best means of preventing complications during facelift surgery. An appreciation of the operative details is complicated not only by the complexity of the anatomy but also by the variability in the nomenclature used.
  
  
  OBJECTIVE
  The authors have attempted to clarify these issues by detailing the relationships of the ligaments of the lower face both to each other and to the marginal mandibular nerve.
  
  
  METHODS
  The mandibular ligament, the platysma mandibular ligament, and the marginal mandibular nerve were identified in 22 cadaver halves. The gonial angle, and the lower mandibular border were used as perpendicular reference lines.
  
  
  RESULTS
  The mean length, height, and depth of the mandibular ligament and the platysma mandibular ligament were calculated. The mean distance of the mandibular ligament from the gonial angle along the mandibular border was also noted:it was always located superior to the platysma mandibular ligament. The marginal mandibular "danger zone" was identified a quarter of the length of the mandibular body along the lower jaw border. Finally variability in nomenclature of the lower face ligaments was clarified.
  
  
  CONCLUSIONS
  A topographic map of the structures of surgical importance in the lower face was constructed in the hope that this will prevent surgical errors during facelift surgery.
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Franziska
authors: F
authors: Huettner
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Steven
authors: S
authors: Rueda
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Cemile N
authors: CN
authors: Ozturk
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Can
authors: C
authors: Ozturk
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Richard
authors: R
authors: Drake
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: Claude-Jean
authors: CJ
authors: Langevin
authors: Dr Huettner is an Academic Clinical Associate, Dr Rueda is a Resident, and Dr Zins is the Chairman, Department Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Drs C.N. and C. Ozturk are Academic Clinical Associates, Department of Head, Neck and Plastic Surgery, Roswell Park Cancer Institute, Buffalo, New York. Dr Drake is Director of Anatomy and Professor of Surgery, College of Medicine, Cleveland Clinic, Cleveland, Ohio. Dr Langevin is an Assistant Professor, Plastic and Reconstructive Surgery Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors: James E
authors: JE
authors: Zins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000033:anatomy & histology*; D008297:Male; D008334:Mandible / Q000033:anatomy & histology*; D008340:Mandibular Nerve / Q000033:anatomy & histology*; D008875:Middle Aged