A subset of patients seeking improvement in their neck present with a discrepancy between the subplatysmal volume and the musculoskeletal space within which it resides. Often this imbalance in volume and capacity is the primary contributor to a poorly defined jawline and an obtuse cervicomental angle. To achieve an optimal outcome in the management of these patients subplatysmal surgery is required.

In patients with heavy, obtuse necks secondary to an imbalance between the mandibular size and excess volume of subplatysmal structures the surgeon must often modify the deep fat, anterior digastric muscles, reposition the hyoid and/or reduce the submandibular gland. A clear understanding of the spatial relationship and complex anatomy of these structures are necessary to successfully perform a deep cervicoplasty.

The rational and indications for operating on the subplatysmal structures will be presented. Sequential management of the subplatysmal structures with video instruction guide will provide the step-by-step approach to successfully sculpt the anterior neck.

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