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 loss of the youthful face and neck contours. A ``lazy S-shaped'' plication involving the superficial musculoaponeurotic system (SMAS)-Platysma has been performed to recover the face and neck contour. On the neck, the posterior segment of the lateral portion of the muscle was stretched upward and backward to the mastoid. On the face, plication was done laterally and superiorly to the corner of the mouth toward the zygomatic arch. The anterior platysmal bands were approached in the midline to reinforce the muscle sling of the neck. Extensive skin dissection with suction lipectomy under direct visualization of the submental and cervical fat were associated. Photographs were taken preoperatively, 1 year, and 10 years after the surgery. Face and neck contour at 10 years was compared with that at 1 year after the surgery and with the patient look before the surgery. Improvement of the face and neck contour was achieved in all patients at 1 year postoperatively. At 10 years after the surgery the face and neck contour was equal or eventually better than before the surgery.