Abstract:
The aim of any neck lift obviously includes the restoration of an acute cervicomandibular angle. The hyo neck lift, first published in April 2016, did proposed a new technique of neck lift with a sub-cutaneous neck dissection and suture of the platysma to the hyoid through this sub-cutaneous approach. To enhance results and efficiency, a major change of the hyo neck lift technique is herein proposed with a vertical anterior sub-platysmal and sub-platysmal fat opening and dissection. This anterior dissection ensures a precise and efficient fixation of the platysma to the deep cervical fascia on direct visual control. This permits to create an horizontal and posterior vector of tension on both platysma and skin, which induces flattening of the submental area and consequently creates or recreates an acute cervicomandibular angle. The sub-cutaneous dissection is no more necessary at the hyoid level. In addition, the posterior border of the anterior platysmal flap is suspended to the mastoid fascia. If necessary, the submandibular gland, through this lateral approach, can be partially excised inside it\'s capsule, after strong bipolar coagulation. A botulinum toxin injection, realized in early post-op, will definitively stabilize the platysma to deep cervical fascia fixation. Fifteen patients underwent the new technique of neck lift with fixation of the platysma to the deep cervical fascia and suspension of the lateral platysma (Platysma Fixation Platysma Suspension: PF PS) and were evaluated at one year post-op and compared to the results obtained with the first preliminary prospective study \"hyo neck lift technique\" published in April 2016. As now subcutaneous dissection is limited, recovery is faster. No transient nerve damage happened because dissection planes are designed to be far from nerve branches.
CONCLUSIONS: The simplest way to obtain an acute cervicomandibular angle is to reattach the platysma to the deep cervical fascia along the platysma cords. The new neck lift with fixation of the anterior platysma to the deep cervical fascia and suspension of the lateral platysma, is faster to perform, induces a faster recovery and is safer and more efficient than the subcutaneous hyo neck lift and other described types of anterior platysma plasties.
摘要:
任何颈部提升的目的显然包括恢复急性颈下颌角。hyo颈部提升器,首次发表于2016年4月,确实提出了一种新的颈部提升技术,即皮下颈清扫术,并通过这种皮下入路将颈阔肌缝合至舌骨.为了提高成果和效率,本文提出了hyo颈提升技术的主要变化,包括垂直的前颈下和颈下脂肪开放和解剖。这种前路解剖可确保在直接视觉控制下将颈阔肌精确有效地固定在颈深筋膜上。这允许在颈阔肌和皮肤上产生水平和后向张力矢量,这会导致下区变平,从而产生或重建急性颈下颌角。在舌骨水平不再需要皮下解剖。此外,颈前皮瓣的后边界悬挂在乳突筋膜上。如有必要,颌下腺,通过这种横向方法,可以在它的胶囊内部分切除,强双极凝血后。肉毒杆菌毒素注射,在术后早期意识到,将确定稳定颈阔肌对颈深筋膜的固定。15例患者接受了将颈肌固定到颈深筋膜并悬吊外侧颈肌的新技术(PlatismaFixationPlatismaSuspension:PFPS),并在术后一年进行了评估,并与结果进行了比较。2016年4月发表的第一项初步前瞻性研究“hyo颈提升技术”。因为现在皮下夹层是有限的,恢复更快。没有发生短暂的神经损伤,因为解剖平面被设计为远离神经分支。
结论:获得急性颈下颌角的最简单方法是将颈阔肌沿着颈阔肌索重新连接到颈深筋膜。新的颈部提升与前颈阔肌固定到颈深筋膜和悬吊侧颈阔肌,执行速度更快,诱导更快的恢复,并且比皮下hyo颈提升和其他描述类型的前颈阔肌假体更安全,更有效。