The Platysma Window: An Anatomically Safe, Efficient, and Easily Reproducible Approach to Neck Contour in the Face Lift

Background: The cornerstone of the face lift is neck contour. The pursuit of reliable and reproducible results has led plastic surgeons to investigate a multitude of different approaches. Unfortunately, addressing neck contour can lead to complications such as injury to the great auricular nerve. The purpose of this study was to describe an efficient, safe, and reproducible technique of improving face lifts: the platysma window. Methods: The authors use a reference point located one fingerbreadth inferior to the angle of the mandible and one fingerbreadth anterior to the anterior border of the sternocleidomastoid muscle. A two-fingerbreadth incision is made on the muscle to open a small "window," approximately 2 cm of total vertical flap length. Two figure-of-eight 4-0 Mersilene sutures are placed from the window to the mastoid fascia, spanning the great auricular nerve at McKinney's point. Results: The platysma window technique is designed to minimize the complications of neck lifts-especially the risk of injury to the great auricular nerve. Placing the window inferior and anterior to these structures ensures a safe area for executing platysma tightening. This maneuver can augment a myriad of face-lifting techniques. The authors have used the maneuver described in over 200 cases, with consistently repeatable and improved neck contour results. Conclusions: Patients demand expedient and safe procedures in addition to an excellent cosmetic outcome. Plastic surgeon should try to meet their patients' needs; the authors believe the platysma window can play a role in becoming a useful method available to surgeons when addressing neck contour in face lifting. (Plast. Reconstr. Surg. 129: 1169, 2012.)