Face lift, part 5: suspending sutures for platysma cording.

We describe the technical details used in applying nonabsorbable sutures running from the anterior platysma muscles and/or adjacent fascia back to the fascia just in front of or covering the sternocleidomastoid muscles. These sutures usually pass 1.5-2 cm below the angle of the mandible. Anteriorly, they cover or are attached to the platysma muscles at the level of the cervical concavity or angle. The sutures suspend or draw back the superficial musculoaponeurotic system (SMAS) at this level, preventing some of the anterior displacement of the platysma when it is contracted in normal use. We believe that the sutures have relatively long-lasting effects and that they delay the early return of "platysma cording" after cheek-neck lifting. Their application using Reverdin and Keith needles is demonstrated. Differences in technique when submental lipectomy is and is not performed with the lift are shown.