Submental area rejuvenation by digastric corset: anatomical study and clinical application in 20 cases.

UNLABELLED: Knowing the difficulties and limitations of surgery for rejuvenating the submental area during a cervicofacial rhytidectomy, we came up with the concept of the digastric corset, which is described in this article along with the surgical importance of the platysma, digastric and mylohyoid muscles based on anatomical dissections. A study of ten cadavers was conducted to describe precisely the limits of the submental area, the mandibular edge between the two Furnas ligaments, and the hyoid bone. Each anatomical item was dissected plane by plane: the skin, platysma, digastrics muscles, and mylohyoid muscle. The sliding of each muscle relative to the others was studied, photographed, and recorded. Feldman's corset technique was tested on two cadavers and a digastric corset was performed on eight cadavers. After suprahyoid fat lipectomy, we suture the digastric retaining ligaments to the mylohyoid muscles using a running suture, like a corset, then the platysma muscles are put aside on the median line followed by lateral platysma suspension. The different steps are presented and the results of 20 patients who underwent this procedure are presented after 1 year of follow-up. This study showed that the technique of a digastric corset anchored on the mylohyoid allows for one-step reconstruction of the floor of the mouth and a well-defined anterior cervical angle, a sign of a youthful-looking neck. This technique is indicated for difficult necks, when lateral repositioning of the platysma alone gives insufficient results. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .