A 26-year experience with vest-over-pants technique platysmarrhaphy.

BACKGROUND The purpose of this article is to review the efficacy of the vest-over-pants technique for elimination of the platysma bands and improvement of the cervicomental angle. METHODS This is a retrospective chart review of 88 patients with neck aging selected randomly by a visiting fellow and a medical student. The collected information included patient demographics, cervical surgical techniques, and complications. Patient photographs obtained preoperatively and at least 8 months postoperatively were compared on front and profile views to determine the visibility of the platysmal bands and the neck contouring. Through an incision placed anterior to the submental crease, the platysma borders were identified and elevated. After completion of the other intended procedures, the platysma borders were then overlapped using the vest-over-pants technique with 4-0 Mersilene. RESULTS The mean patient age was 57.56 years. There were 76 women (86.4 percent) and 12 men (13.6 percent). The average follow-up was 28.8 months. Of the 88 patients, 93.2 percent underwent concomitant rhytidectomy, 94.3 percent underwent submental lipectomy, 95.9 percent underwent submandibular contouring, 61.4 percent underwent removal of the anterior belly of the digastric muscle, and 5.7 percent underwent suspension or partial or total excision of the submandibular salivary gland. None of the patients had residual recurrence of the platysma bands during the follow-up period. CONCLUSION On the basis of the detailed analysis of this group of patients and 26-year experience with this technique, the authors conclude that this procedure provides logical and enduring elimination of prominent platysma bands and suspension of neck structures.