Athena Vale
The platysma is a thin, superficial muscle in the neck that contributes to a variety of facial expressions. It is often overlooked due to its location, but it plays a key role in producing facial expressions and has several insertion points. Its medial fibres insert into the lower border of the mandible or the skin of the lower lip, while its lateral fibres attach to the muscles surrounding the mouth. The platysma is vulnerable to neck injuries and can be tested through ultrasound imaging or computed tomography angiography to visualise any damage. Testing the platysma is important to understand its function and role in facial expressions, as well as to identify any potential issues or injuries.
| Characteristics | Values |
|---|---|
| Location | Superficial muscle in the neck |
| Covered area | Anterior and lateral aspect of the neck |
| Origin | Fascia that covers the clavicle, acromial region, pectoralis major and deltoid muscles |
| Insertion | Mandible, cheek skin, commissure of the mouth, orbicularis oris muscle, posterior border of the depressor anguli oris muscle |
| Nerve supply | Cervical branch of the facial nerve (CN VII) |
| Arterial supply | Submental branch of the facial artery, suprascapular branch of the thyrocervical trunk |
| Veins covered | External and anterior jugular veins |
| Function | Contributes to producing facial expressions, elevates the neck, lowers midfacial tissues |
| Testing | Ultrasound imaging, computed tomography angiography, palpation |
| Ageing | Appearance of platysma bands or ridges, wrinkly skin on the neck |
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What You'll Learn
Platysma muscle anatomy
The platysma muscle is a superficial muscle in the human neck that plays a role in facial expressions and certain movements of the lower face and neck. It is a broad, thin muscle that lies just beneath the skin, covering the front part of the neck and extending from the chest up to the face. The platysma is divided into two sections—right and left—which may meet in the midline or have a small gap between them.
The platysma originates from the fascia that covers the superior portions of the pectoralis major and deltoid muscles. Its fibres cross the clavicle and proceed obliquely upward and medially along the side of the neck. The platysma passes over the clavicle and ascends through the anterolateral sides of the neck, passing over the external and anterior jugular veins. The muscle fibres thin out anteriorly and attach just behind the symphysis menti. On the lateral side, the fibres pass over the mandible, with some inserting into the bone and others merging with the subcutaneous tissues.
The platysma has several insertion points. Its medial fibres insert onto the lower border of the mandible or the skin of the lower lip. The lateral fibres attach to the skin and subcutaneous tissue of the perioral region, and to the muscles surrounding the mouth. 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 in a frown. The platysma also blends with the depressor anguli oris and depressor labi inferioris muscles, reinforcing their actions.
The platysma is supplied by the cervical branch of the facial nerve and receives arterial blood supply from the submental branch of the facial artery and the suprascapular branch of the thyrocervical trunk. It is vulnerable to neck injuries that may penetrate it due to its superficial and thin nature.
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Platysma muscle function
The platysma muscle is a thin, sheet-like muscle located in the superficial layer of the cervical fascia in the subcutaneous tissue of the neck. It is a facial expression muscle that contributes to producing a myriad of facial expressions. It is supplied by the cervical branch of the facial nerve (CN VII) and receives arterial blood supply from the submental branch of the facial artery and the suprascapular branch of the thyrocervical trunk.
The platysma muscle covers the anterior and lateral aspects of the neck, overlapping the sternocleidomastoid muscle. Its fibres originate from the fascia covering the upper parts of the pectoralis major and deltoid muscles, crossing over the clavicle and proceeding obliquely upward and medially along the side of the neck. The muscle 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 around the mouth.
The main function of the platysma muscle is to contribute to facial expressions. When contracted, it produces a slight wrinkling of the neck and a ""bowstring" effect on either side of the neck. It also plays a role in depressing the lower jaw, drawing down the lower lip, and creating a frown. However, the platysma's role in depressing the lower lip is minor compared to the depressor anguli oris and depressor labii inferioris muscles.
The platysma muscle can be activated by asking a patient to depress and draw their lower lip laterally while maintaining a slightly depressed mandible position. It is vulnerable to injuries, tears, strains, and atrophy, and its tone can affect the healing process of neck wounds, requiring careful suturing to prevent large scarring. The platysma is also associated with ageing in the neck, as the appearance of platysma bands or ridges can occur with a decrease in muscle tone, leading to a "turkey neck" appearance.
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Platysma muscle injuries
The platysma muscle is a thin, superficial muscle in the human neck that covers the anterior surface of the neck. Its main function is to contribute to producing a myriad of facial expressions. The platysma is vulnerable to neck injuries that may penetrate it, as it is both superficial and thin. Penetrating trauma in the neck can be defined as any injury that completely penetrates the platysma muscle.
When neck surgery is performed for various reasons, the platysma muscle usually needs to be cut through to access deeper structures in the neck. This makes the platysma vulnerable to injury during surgery. Accurate suturing of the platysma fibres is essential to prevent abnormal scar retraction, which may result in unsightly scarring. Additionally, the platysma's close association with underlying neurovascular structures, such as the cervical branch of the facial nerve, means that special care is required during surgical dissections to avoid damage to these structures.
The platysma muscle is also susceptible to trigger points, which are specific areas in the muscle that radiate pain to other parts of the body. Platysma trigger points can cause cheek pain, headaches, migraines, and TMJ (temporomandibular joint) dysfunction. Therapeutic treatments for soft tissue injuries, such as massage therapy, manual therapy, and trigger point therapy, can be effective in managing platysma trigger points and associated conditions.
In addition to traumatic and surgical injuries, the platysma muscle can be affected by age-related changes. With ageing, platysma bands or ridges may form, running the entire length of the muscle. These bands can be aggravated by factors such as weightlifting or facelift procedures, resulting in a condition known as platysma dyskinesia or "turkey neck". Conservative management or interventions such as botulinum toxin injections and platysmaplasty (a type of surgery) can be considered for treatment.
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Platysma muscle testing methods
The platysma muscle is a superficial muscle in the human neck that overlaps the sternocleidomastoid. Its thin muscle fibres cross over the clavicle and proceed obliquely superiorly, laterally, and medially over the neck. The platysma can be activated by asking the patient to depress and draw the lower lip laterally while slightly depressing the mandible. Trigger points in the platysma can result from acute or chronic overuse of the muscles, for example, repeated expressions of disgust or horror.
- Real-time ultrasound imaging: This method involves using ultrasound to measure the increase in local muscle thickness and mobility within and outside of a platysmal band. The participant is seated in a 45-degree position with their head reclined, first relaxed, and then with their platysma maximally contracting, showing their lower teeth.
- Computed Tomography Angiography (CTA): CTA is used to visualise arteries and veins and is particularly useful for complex injuries such as gunshot or stab wounds.
- Palpation: This method involves feeling the muscle with the hands to detect any abnormalities or trigger points.
- Conservative management: This approach includes non-invasive treatments such as botulinum toxin injection and platysmaplasty, a surgery that can be open or closed.
It is important to note that the platysma is vulnerable to neck injuries due to its superficial and thin nature. Therefore, special care is required during surgical dissections to prevent damage to the underlying neurovascular structures.
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Platysma muscle treatment
The platysma muscle is a thin, sheet-like muscle in the human neck. It is vulnerable to neck injuries, tears, strains, and muscle atrophy. Platysmal bands, or "turkey neck", become more visible with age, muscle activity, and genetics. While treatment for platysmal bands is not necessary, some people may want to reduce their appearance. Conservative management and non-invasive options are available, as well as more expensive surgical procedures.
Conservative Management
Conservative management options include botulinum toxin (Botox) injections, which can help relax the muscles in the neck and reduce the appearance of platysmal bands.
Non-Invasive Options
Non-invasive options include injectables and lasers, which can be administered by a cosmetic dermatologist.
Surgical Procedures
Surgical procedures are typically performed by a plastic surgeon or an ENT facial plastic surgeon. These procedures are more expensive but considered more effective. One such procedure is platysmaplasty, which tightens the skin and muscles at their weakest points, resulting in a smoother neck and sharper jawline. Platysmaplasty can be performed as open surgery or with a specialised instrument called a plastymotome that allows the surgery to be done without incisions. Liposuction of the neck can also be performed without piercing the platysma muscle.
Preventative Measures
Preventative measures can be taken to avoid platysmal bands, such as being aware of your neck during high-intensity workouts and relaxing your neck when it tenses.
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Frequently asked questions
The platysma muscle is a superficial muscle in the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially.
The platysma muscle is located within the subcutaneous tissue of the neck (superficial layer of the cervical fascia). Its fibres cross the clavicle and proceed obliquely upward and medially along the side of the neck.
The platysma muscle contributes to producing a myriad of facial expressions. It also plays a role in preventing the compression of the jugular veins and the suction of the soft tissues of the neck during strenuous physical activity.
Platysma synkinesis is a secondary complication of facial palsy. It results in abnormal synchronisation of facial movement, causing involuntary facial movement during voluntary movement of a different facial muscle group. To test for platysma synkinesis, ask the patient to forcefully depress and draw the lower lip laterally while maintaining the mandible in a position of slight depression.
Platysmal banding refers to the neck bands in the area above the platysma muscle that become more noticeable with age. These bands can be visualised using computed tomography (CT) and ultrasound imaging.
