title: Anatomy of the Cervicomental Region: Insights From an Anatomy Laboratory and Roundtable Discussion.
abstract: In 2015, ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was approved as a first-in-class injectable drug for reduction of submental fat. Use of a pharmacologic/injectable therapy within the submental region requires a thorough understanding of cervicomental anatomy to ensure proper injection technique and safe administration. To this end, an anatomy laboratory was conducted to review key external landmarks and important internal anatomic structures that characterize the lower face and anterior neck. External landmarks that define the boundaries of the cervicomental and submental regions were identified including the inferior mandibular border, the anterior border of the sternocleidomastoid muscle, the antegonial notch, the submental crease, the thyroid notch, and the hyoid bone. Relevant internal anatomic structures, including preplatysmal submental fat (the target tissue for ATX-101) and the platysma muscle as well as critical neurovascular and glandular tissues were revealed by dissection. Of particular interest was the marginal mandibular branch of the facial nerve because it typically courses along the inferior mandibular border near the proposed treatment area for ATX-101.
authors: *Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; †Department of Dermatology, University of California Los Angeles and Private Practice (Skin Care and Laser Physicians of Beverly Hills), Los Angeles, California; ‡Private Practice, Boca Raton, Florida; §Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Missouri; ‖Private Practice (Total Skin & Beauty Dermatology Center, P.C.), Birmingham, Alabama and Departments of Dermatology and Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; ¶Evidence Scientific Solutions, Philadelphia, Pennsylvania; **Department of Otolaryngology/Facial Plastic Surgery, University of California Davis Medical Center, Sacramento, California.
authors: Jeffrey M
authors: JM
authors: Kenkel
authors: Derek H
authors: DH
authors: Jones
authors: Steven
authors: S
authors: Fagien
authors: Dee Anna
authors: DA
authors: Glaser
authors: Gary D
authors: GD
authors: Monheit
authors: Karen
authors: K
authors: Stauffer
authors: Jonathan M
authors: JM
authors: Sykes
mesh_terms: D000328:Adult; D000368:Aged; D000715:Anatomy / Q000193:education*; D002102:Cadaver; D002680:Chin / Q000033:anatomy & histology*; D004210:Dissection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology*