Remembering The Platysma Muscle: A Simple 3-Step Method

The platysma muscle is a thin, sheet-like muscle located in the anterior region of the neck. It is responsible for producing a range of facial expressions and plays a role in depressing the lower lip and jaw. Given its location and function, understanding the platysma muscle is crucial in both clinical and aesthetic applications. This muscle is vulnerable to various conditions such as tears, strains, and atrophy, and its superficial position has significant implications for surgical procedures and wound management.

Platysma muscle anatomy

The platysma muscle is a thin, sheet-like muscle in the human neck that plays a role in facial expressions and certain movements of the lower face and neck. It is a superficial muscle, arising from the fascia that covers the pectoralis major and deltoid muscles in the upper thorax, shoulder, and chest regions. It passes over the clavicle and ascends through the anterolateral sides of the neck, attaching to the mandible and the skin and muscles of the lower face.

The platysma has a significant facial component, extending superiorly onto the face. It inserts into the lower border of the mandible (jawbone) and the skin and muscles around the mouth, including the orbicularis oris muscle and the depressor anguli oris muscle. The platysma contributes to the formation of the modiolus, a fibromuscular chiasm of facial muscles found in the corners of the mouth, and the orbicularis oris complex.

The platysma is innervated by the facial nerve (cranial nerve VII), with the primary innervation being by the cervical branch. It receives arterial blood supply from branches of the submental and suprascapular arteries. The platysma covers deeper structures in the neck, such as the external carotid artery, the external jugular vein, the parotid gland, and several nerves.

The platysma is vulnerable to neck injuries due to its superficial and thin nature. It can be seen bulging out during strenuous physical activity, and its contraction can cause a bowstring" effect on the sides of the neck and a wrinkling of the skin. In some cases, it may also cause a slight depression of the skin of the mandible or drooping of the lower lip and angle of the mouth.

The platysma is clinically significant in surgical procedures, particularly neck surgeries where it may need to be cut through. Accurate suturing is important to prevent abnormal scar retraction and aesthetic concerns. It is also important to consider the underlying neurovascular structures when operating in the area of the platysma muscle.

Platysma muscle function

The platysma muscle is a thin, sheet-like muscle that lies superficially within the anterior aspect of the neck. It is often overlooked, but it is a muscle of facial expression that contributes to producing a myriad of facial expressions. The platysma is a part of a finely coordinated neuromuscular complex that allows humans to communicate through facial expressions.

The platysma is contained within the superficial cervical fascia, which is a zone of loose connective tissue between the dermis and deep cervical fascia. It originates from the fascia that covers the clavicle, the acromial region, and the superior portions of the pectoralis major and deltoid muscles. Its fibres ascend superomedially over the anterolateral aspect of the neck, attaching to the mandible and the skin and subcutaneous tissue of the lower face. The platysma has several insertion points, with its medial fibres inserting onto the lower border of the mandible or the skin of the lower lip, and its lateral fibres attaching to the skin and subcutaneous tissue surrounding the mouth.

The platysma receives arterial blood supply from the submental branch of the facial artery, as well as the suprascapular branch of the thyrocervical trunk. It is innervated by the facial nerve (cranial nerve VII), with its primary innervation being by the cervical branch. The platysma also receives proprioceptive innervation from the transverse cervical nerve.

Contraction of the platysma muscle causes a slight wrinkling of the skin on the neck and a "'bowstring' effect on either side of the neck". It also contributes to the formation of the modiolus, a fibromuscular chiasm of facial muscles found in the corners of the mouth. The platysma can be seen bulging out during strenuous physical activity, which is thought to prevent the compression of the jugular veins and the suction of the soft tissues of the neck. Additionally, contraction of the platysma can result in the lowering of midfacial tissues, including the lower eyelids and midface, deepening the malar and nasolabial folds, and depressing the mandible, thereby making the neck shorter and wider. This type of contraction can convey emotions such as surprise, horror, or disgust.

Platysma muscle innervation

The platysma muscle is a thin, sheet-like muscle that lies superficially within the anterior aspect of the neck. It is a facial expression muscle and is therefore innervated by the facial nerve (cranial nerve VII).

The facial nerve has several main branches: the temporal, zygomatic, buccal, marginal mandibular, and cervical branches. The primary innervation of the platysma is by the cervical branch, which runs just deep to the platysma. This branch supplies the platysma and the depressor anguli oris muscle, so damage to it could result in paralysis of these muscles, causing distortion to the shape of the mouth and the skin over the anterior neck region.

The platysma also receives proprioceptive innervation from the transverse cervical nerve. In addition, it receives arterial blood supply from the submental branch of the facial artery, as well as the suprascapular branch of the thyrocervical trunk.

The platysma is supplied by branches of the submental artery and suprascapular artery. It lies just deep to the subcutaneous fascia and fat, covering many deeper structures in the neck, such as the external carotid artery, the external jugular vein, the parotid gland, the lesser occipital nerve, the great auricular nerve, and the marginal mandibular branch of the facial nerve.

Platysma muscle in facial expressions

The platysma muscle is a thin, sheet-like muscle located in the anterior aspect of the neck. It is a superficial muscle, meaning it lies just under the subcutaneous tissue of the neck. Due to its location, the platysma is often overlooked as a muscle of facial expression. However, it plays a crucial role in producing a range of facial expressions.

The platysma muscle arises from the fascia that covers the upper parts of the pectoralis major and deltoid muscles. Its fibres ascend superomedially, crossing over the clavicle and proceeding obliquely upward and medially along the side of the neck. The platysma has several insertion points, including the mandible, the skin of the lower lip, and the muscles surrounding the mouth.

One of the main functions of the platysma muscle is to contribute to facial expressions. When the entire platysma muscle is in action, it produces a slight wrinkling of the skin on the neck and a distinctive ""bowstring" effect on either side of the neck. The anterior portion of the platysma muscle, the thickest part, depresses the lower jaw and draws down the lower lip and angle of the mouth, contributing to expressions of sadness, surprise, and horror. Additionally, the platysma blends with other muscles of facial expression, such as the depressor anguli oris and depressor labi inferioris muscles, reinforcing their actions.

The platysma muscle is also involved in strenuous physical activities, such as running. During such activities, the platysma can be seen bulging out, which is believed to prevent the compression of the jugular veins and the suction of soft tissues in the neck due to intense respiratory efforts. This mechanism highlights the importance of considering the platysma muscle during surgical procedures involving the neck, as injuries or improper suturing can result in large scarring or distortion of the shape of the mouth and neck region.

Furthermore, the platysma muscle plays a role in facial cosmetic procedures. For example, injecting botulinum toxin (Botox) into the platysma can temporarily paralyze it, reducing wrinkles and preserving the elasticity of the skin. This procedure is known as platysmaplasty and can be performed open or closed, with the latter utilizing a specialized instrument called a plastymotome to avoid incisions.

Platysma muscle in cosmetic surgery

The platysma muscle is a thin, sheet-like muscle that covers the anterior and lateral aspects of the neck. It is a muscle of facial expression, contributing to the formation of the orbicularis oris complex, which enables a myriad of facial expressions. The platysma is also involved in depressing the lower jaw, drawing down the lower lip and angle of the mouth in a frown.

In cosmetic surgery, the platysma muscle is relevant in procedures such as neck lifts, also known as platysmaplasty. This type of surgery is often performed to address age-related changes in the neck, including loose and sagging skin, platysmal bands, and excess fat. Neck lifts can be performed as a standalone procedure or in conjunction with other surgeries such as liposuction, facelift, chin implant, or rhinoplasty. During a neck lift, the surgeon will tighten the platysma muscle, remove fat, reposition tissue under the neck, and trim away excess skin to achieve a more youthful and contoured appearance.

The recovery process for platysmaplasty can take a few weeks, and patients should follow their surgeon's instructions to ensure a safe and successful recovery. Some potential risks and side effects associated with the procedure include pain, muscle tightness, swelling, bruising, temporary hair loss along incisions, and changes in skin sensation.

It is important to select a skilled and experienced plastic or facial plastic surgeon for platysmaplasty. The surgeon should be fellowship-trained and board-certified to reduce complications and increase the likelihood of a safe and successful operation. Preoperative assessments are also crucial, including evaluating the amount of excess skin, the depth of platysma bands, and the examination of submandibular glands and the digastric muscle.

In summary, the platysma muscle is an important anatomical structure in the neck that contributes to facial expressions and can be addressed through cosmetic procedures such as platysmaplasty or neck lifts to enhance the appearance of the neck and jawline by tightening the muscle and improving skin contour.

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