The changing role of platysma in face lifting.

Since the 1970s, surgical procedures on platysma muscle, aiming to achieve better results in face lifting, became popular and turned out to be an important surgical step for the plastic surgeon. Many plastic surgeons have contributed to the topic throughout these years, as several articles on the subject have been published. Articles dealing with platysma muscle still bring great interest among plastic surgeons. My concern with platysma muscle began in the mid-1970s and since then has grown continuously. I have steadily been studying the importance of the platysma muscle in the surgeries for facial rejuvenation, involving its anatomy, the techniques proposed, the results obtained, the recommendations for the best surgical procedure for each patient, and the complications. My experience and studies regarding platysma muscle, and the contributions I have brought into this field, are thoroughly described and discussed in this article.

Custom-made rhytidoplasty.

The necessity to provide a particular surgical plan for each patient who seeks surgery for facial rejuvenation is stressed in this paper. The constant evolution of surgical procedures for rhytidoplasty have introduced several new procedures to attain the same goal. The pitfalls of using the same technique for each patient and also the utilization of very extensive procedures are discussed.

Mammaplasty utilizing the periareolar approach.

An analysis of 300 cases of reduction mammaplasty done utilizing a periareolar approach at the University Hospital of the State of Rio de Janeiro and our own private clinic during the period from September 1989 through October 1995 is presented in this article. The technical evolution of this procedure is described in detail as well as how the complications were eliminated and the aesthetic results improved. A thorough analysis of recommendations and comments on the results are made by the authors.

Massive breast hypertrophy in a young girl.

A patient with massive virginal breast hypertrophy is reported in this study. A 16-year-old girl presented with abnormal growth of her breasts in 1 year. Due to the enormous breast volume, which caused her physical and psychological problems, she curtailed her social life. After a thorough gynecological and breast assessment, she was referred to the plastic surgery division for breast reduction. She underwent total subcutaneous mastectomy followed by immediate breast reconstruction by subpectoral prosthesis implantation.

Analysis of 60 cases of simultaneous mammaplasty and abdominoplasty.

The authors report 60 cases of simultaneous breast and abdomen reduction and analyze the value of its use. The combined procedure remodels the body contour with excellent results and low morbidity.

Convergent nipple-areolar complexes corrected by inferior curved pedicle technique.

We report a case of mammaplasty followed by a marked convergence of the nipple-areolar complex and describe the surgical repair by means of an inferior dermal-fat curved flap. The curve of the inferior pedicle permits one to raise the nipple to its normal position with ease and exceptional viability, even if a breast reduction procedure is associated.

Limited incisions in abdominoplasty.

Presented here is our experience with a new approach to abdominoplasty using a limited incision with liposuction. The indications and advantages of the proposed technique are discussed. The procedure was performed in 20 consecutive cases. The benefits of the procedure are the resultant natural contour of the abdominal wall and umbilicus, the maintenance of the mons pubis at its original site, and, most importantly, a limited scar.

T abdominoplasty to remove multiple scars from the abdomen.

A patient presented with multiple scars on the abdomen from previous surgical procedures. Much of the scarring was eliminated and the form of the abdomen restored by an atypical inverted T abdominoplasty.

The value of anatomical study of the platysma muscle in cervical lifting.

Medial fibers of the platysma muscle present anatomical variations at the submental area. It is important that patients be operated on according to the anatomical distribution of these fibers. The method described is easy and safe, based on anatomical studies and on clinical observations. It is another option for the treatment of cervicofacial deformities.

Extensive cervical and lower face lipectomy: its importance and anatomical basis.

The authors propose a more extensive lipectomy than usual along and above the mandibular branch, to obtain better results in the neck and lower face in rhytidectomy. The operative technique is based on anatomical findings. Results are excellent when the procedure is indicated and properly performed. Lipectomy is recommended in patients with abnormal fat deposits about the lower face and neck; it is not advised for obese patients.