The "lazy S-shaped" plication of the SMAS-Platysma musculoaponeurotic system: A 10-year review

Morphological changes that appear with the aging process are expressed by l oss of the youthful face and neck contours. A "lazy S-shaped" plication inv olving the superficial musculoaponeurotic system (SMAS)-Platysma has been p erformed to recover the face and neck contour. On the neck, the posterior s egment of the lateral portion of the muscle was stretched upward and backwa rd to the mastoid. On the fact, plication was done laterally and superiorly to the corner of the mouth toward the zygomatic arch. The anterior platysm al bands were approached in the midline to reinforce the muscle sling of th e neck. Extensive skin dissection with suction lipectomy under direct visua lization of the submental and cervical fat were associated. Photographs wer e taken preoperatively, 1 year, and 10 years after the surgery. Face and ne ck contour at 10 years was compared with that at 1 year after the surgery a nd with the patient look before the surgery. Improvement of the face and ne ck contour was achieved in all patients at I year postoperatively. At 10 pe ars after the surgery the face and neck contour was equal ol eventually bet ter than before the surgery.