Closed Platysmotomy: A New Procedure for the Treatment of Platysma Bands Without Skin Dissection

Platysma muscular bands are present during the aging period, generally starting in the second half of the fourth decade of life in both sexes. One or two bands along the anterior segment of the neck are the most frequent, with varied extensions and appearances. The literature records different techniques for solving the problem of platysma bands. All the methods involve submental incision, cutaneous dissection, and various tactics for eliminating the action of the platysma bands. This report aims to describe a procedure for deactivating these bands using a percutaneous approach that eliminates the need for submental, cutaneous incision and dissection. This technique involves the use of a steel wire loop that encircles the platysma band and is connected to a device known as the platysmotome through two puncture holes in the skin. Three to six sections along each band eliminate the platysma band, leaving no visible marks on the skin. This method is indicated as an isolated procedure for patients with visible platysma bands and no skin flaccidity, patients with recurring bands after face-lifting and no cervical skin flaccidity, patients who have bands with little cervical skin flaccidity but do not care to undergo face-lifting, and patients who undergo face-lifts for platysma bands that include closed platysmotomy and tightening of the platysma by lateral suture. The described technique is a method specifically designed for deactivation of the platysma bands that can be used both in isolation and in conjunction with face-lifting. Because this method avoids submental, cervical incision and dissection, it is a less invasive technique for “deleting” the bands, whether applied alone or in association with face-lifting. From May 2008 to November 2009 (19 months), 61 patients underwent surgery for the correction of platysma bands via percutaneous myotomy. Among them, the first 11 patients received postoperative follow-up evaluation ranging from 8 to 17 months.