Total neck rejuvenation using a modified Fogli approach and selective resection of anterior platysmal bands.

Over the past six years I have modified my approach to the ageing neck by directing my attention to resecting the redundant platysmal bands after strong superior traction of the body of the platysma muscle to the temporoparotid fascia (Loré’s fascia)() instead of suturing medial platysmal bands. This technique is a variation of Fogli’s initial description(); the main difference being that the elevation of the platysma is achieved by a triple cable braided 2/0 suture to the cut edge of Loré’s fascia in front of the tragus, affording a strong, permanent elevation of the middle and the lower third of the platysma as well as a horizontal vector. If the horizontal vector is inadequate to improve the jawline in the submental area, a separate submental incision is made to approach the muscles. When this occurs the redundant muscle bands are resected, not sutured together.