Isolated Medial Platysmaplasty and Harmonization of the Lower Third of Face with Local Fat Autograft: A Case Report.

One of the most common complaints of patients seeking plastic surgery is the presence of age-related changes in the lower third of the face. These often include vertical platysmal bands, a double chin, Venus rings, the absence of the cervico-mental angle, hypertonicity of the muscles in the mental area, and insufficient projection of the chin. The development and implementation of less-traumatic methods of correction of the lower third of the face and harmonization of the projection of the cervico-mental region remain relevant. This article discusses a comprehensive and individualized approach with minimally invasive techniques for correcting age-related changes in the lower third of the face and harmonizing the definition of the jawline. Isolated platysmaplasty with autologous local fat grafting to the chin is effective, safe, minimally invasive, and has a short rehabilitation period, with stable long-term aesthetic outcomes.

Cone-Beam Computed Tomography for Objective Diagnosis of Age-Related Soft Tissue Changes in Lower Face and Neck.

BACKGROUND: An objective assessment of the causes of age-related contour deformities of the soft tissues of the face and neck is very important in esthetic surgery, especially as minimally invasive techniques gain increasing popularity. METHODS: To visualize the tissues that cause age-related soft tissue changes, we performed cone-beam computed tomography (CBCT) in 37 patients who underwent facial and neck rejuvenation procedures in 2021-2022. RESULTS: Vertical CBCT enabled visualization of the causes and degree of tissue involvement in age-related changes in the lower third of the face and neck. CBCT showed the location and condition of the platysma (hypo- [ptosis], normo-, or hyper-tonus), position, thickness, and location (above and/or below the platysma) of fat tissue, presence of ptosis of the submandibular salivary glands, condition of the anterior bellies of the digastric muscles, and the degree of their participation in contours of the cervicomandibular angle, and location of the hyoid bone. Moreover, CBCT enabled demonstrating for the patient the facial and neck contour deformations and discussing the suggested corrective methods using a clear objective visual image. CONCLUSIONS: CBCT in the upright position enables objective assessment of each soft tissue in the age-related deformity of the cervicofacial region and provides an opportunity to plan the appropriate impact on the particular anatomical structures during rejuvenation procedures and estimate their results. This is the only study to date to objectively and clearly visualize the entire topographic anatomy of the soft tissues of the face and neck vertically for plastic surgeons and patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .