IJAR.2026.147
Type of Article: Original Research
Volume 14; Issue 2 (June 2026)
Page No.: 9546-9558
DOI: https://dx.doi.org/10.16965/ijar.2026.147
Demonstration of the Neurovasculature of the Platysma Muscle and Its Role in Facial Reanimation
Naser A. ElSawy *1, Abdullah G. Al-Kushi 2, Naief A Dahran 3, Reham M Filfilan 4, Nada Mohamed Mohamed Soliman 5, Mohammed A. S. Amin 6.
*1,5&6 Department of Anatomy and Embryology, Faculty of Medicine, Zagazig University, Egypt.
2 Department of Anatomy, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia.
3 Department of Basic Medical Sciences College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
4 Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences Umm Al-Qura University, Makkah, Saudi Arabia.
Corresponding Author: Dr. Naser A. ElSawy, Department of Anatomy and Embryology, Faculty of Medicine, Zagazig University, Egypt. ORCiD: 0000-0002-6189-0196 E-Mail: elsawynaser@gmail.com
Abstract
The platysma is a superficial muscle located in the neck overlapping the sternocleidomastoid muscle. It is innervated by the cervical branch of facial nerve. The platysma is a potential candidate for use in free muscle transfer for facial reanimation around the eye due to its lack of muscle bulk. It has been used extensively in intraoral reconstruction. The purpose of this study is to demonstrate the possibility of using platysma free flap through detailing the precise neurovasculature of the platysma in relation to two bony landmarks: the mental protuberance and the angle of the mandible. Measurements were done using calipers to measure the shortest distance from the edge of the insertion of each vessel or nerve to the mark of the mental protuberance or angle of the mandible on the platysma. Measurements were taken to 6 old male German cadavers, 4 Caucasian Umm Al-Qura University, Saudi Arabi and 20 cadavers’ specimens and jars from Human Anatomy and Embryology department, Zagazig University. Our results show there are close proximity to the cervical branch of the facial nerve and the blood vessels of platysma would be attached to the superficial temporal branches and the nerve of platysma attached to an ipsilateral branch of the facial nerve.
Key wards: Platysma, Neurovasculature, Facial Nerve, Muscle Transfer, Mandible.
REFERENCES
[1]. Baur, D et al. The posteriorly based platysma flap in oral and facial reconstruction. Journal of Oral and Maxillofacial surgery. 2002;60(10):1147-1150.
https://doi.org/10.1053/joms.2002.34989
PMid:12378489
[2]. Uehara M. Helman JI. Lillie JH. Brooks SL. Blood supply to the platysma muscle flap: an anatomic study with clinical correlation. Journal of Oral & Maxillofacial Surgery. 2001;59(6):642-656.
https://doi.org/10.1053/joms.2001.23389
PMid:11381387
[3]. Agarwal A. Schneck CD. Kelley DJ. Venous drainage of the platysma myocutaneous flap. Otolaryngology – Head & Neck Surgery. 2004;130(3):357-369.
https://doi.org/10.1016/j.otohns.2003.12.005
PMid:15054379
[4]. Puxeddu R. Dennis S. Ferreli C. Caldera S. Brennan PA. Platysma myocutaneous flap for reconstruction of skin defects in the head and neck. British Journal of Oral & Maxillofacial Surgery. 2008;46(5):383-6.
https://doi.org/10.1016/j.bjoms.2007.11.015
PMid:18207614
[5]. Falcioni M. Taibah A. Russo A. Piccirillo E. Sanna M. Facial nerve grafting. Otology & Neurotology. 2003;24(3):486-499.
https://doi.org/10.1097/00129492-200305000-00022
PMid:12806304
[6]. Boahene K. Reanimating the paralyzed face. F1000Prime Rep. 2013 Nov 1;5:49. https://doi.org/10.12703/P5-49
PMid:24273650 PMCid:PMC3816764
[7]. Neil, A et al. Use of innervated platysma flap in facial reanimation. Annals of plastic surgery. 1995;34(3):326-330.
https://doi.org/10.1097/00000637-199503000-00018
PMid:7598393
[8]. Evans AK. Licameli G. Brietzke S. Whittemore K. Kenna M. Pediatric facial nerve paralysis: patients, management and outcomes. International Journal of Pediatric Otorhinolaryngology. 2005;69(11):1521-8.
https://doi.org/10.1016/j.ijporl.2005.04.025
PMid:15985298
[9]. Yeo SG. Lee YC. Park DC. Cha CI. Acyclovir plus steroid vs steroid alone in the treatment of Bell’s palsy. American Journal of Otolaryngology. 2008;29(3):163-6.
https://doi.org/10.1016/j.amjoto.2007.05.001
PMid:18439948
[10]. Vlastou C. Facial paralysis. Microsurgery. 2006;26(4):278-87.
https://doi.org/10.1002/micr.20240
PMid:16628742
[11]. Tate JR. Tollefson TT. Advances in facial reanimation. Current Opinion in Otolaryngology & Head & Neck Surgery. 2006;14(4):242-253.
https://doi.org/10.1097/01.moo.0000233594.84175.a0
PMid:16832180
[12]. Erni D. Lieger O. Banic A. Comparative objective and subjective analysis of temporalis tendon & microneurovascular transfer for facial reanimation. British Journal of Plastic Surgery. 1999;52(3):167-72.
https://doi.org/10.1054/bjps.1997.3060
PMid:10474465
[13]. Seiff SR. Carter SR. Facial nerve paralysis. International Ophthalmology Clinics. 2002;42(2):103-112.
https://doi.org/10.1097/00004397-200204000-00010
PMid:11914707
[14]. Harii K. Ohmori K. Torii S. Free gracilis muscle transplantation, with microneurovascular anastomoses for the treatment of facial paralysis. A preliminary report. Plastic & Reconstructive Surgery. 1976;57(2):133-43.
https://doi.org/10.1097/00006534-197602000-00001
PMid:1250883
[15]. Kravvas G, Al-Niaimi F. A systematic review of treatments for acne scarring. Part 1: non-energy-based techniques. Scars Burn Heal. 2017;3:2059513117695312.
https://doi.org/10.1177/2059513117695312
PMid:29799567 PMCid:PMC5965325
[16]. Gheisari M, Iranmanesh B, Saghi B. Blunt cannula subcision is more effective than Nokor needle subcision for acne scars treatment. J Cosmet Dermatol 2019;18(1):192-196.
https://doi.org/10.1111/jocd.12523
PMid:29524284
[17]. Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J. 2013;33(6):769-782.
https://doi.org/10.1177/1090820X13495405
PMid:23855010
[18]. Lee S-Y, Sung K-Y. Subcision: an ancillary procedure to face-lift operation to improve prominent nasolabial folds. Arch Plast Surg. 2013;19(2):120-124.
https://doi.org/10.14730/aaps.2013.19.2.120
[19]. Howaldt HP. Bitter K.The myocutaneous platysma flap for the reconstruction of intraoral defects after radical tumor resection. Journal of Cranio-Maxillo-Facial Surgery. 1989;17(5):237-240.
https://doi.org/10.1016/S1010-5182(89)80076-9
PMid:2760228
[20]. Szudek J. Taylor SM. Systematic review of the platysma myocutaneous flap for head and neck reconstruction. Archives of Otolaryngology — Head & Neck Surgery. 2007;133(7):655-661.
https://doi.org/10.1001/archotol.133.7.655
PMid:17638777
[21]. Friedman M. Schild JA. Venkatesan TK. Platysma myocutaneous flap for repair of hypopharyngeal strictures Annals of Otology, Rhinology & Laryngology. 1990;99(12):945-450.
https://doi.org/10.1177/000348949009901203
PMid:2244726
[22]. Lazaridis N. Dimitrakopoulos I. Zouloumis L The superiorly based platysma flap for oral reconstruction in conjunction with neck dissection: a case series. 2007;65(5):895-900.
https://doi.org/10.1016/j.joms.2006.06.296
PMid:17448839
[23]. Dadkhahfar S, Robati RM, Gheisari M, Moravvej H. Subcision: indications, adverse reactions, and pearls. J Cosmet Dermatol. 2020;19(5):1029-1038.
https://doi.org/10.1111/jocd.13308
PMid:31990113
[24]. Cartier C, Jouzdani E, Garrel R, Makeieff M, Crampette L, Guerrier B. Study of the platysma coli muscle vascularisation by the facial artery. Implication during the elevation of the musculo-cutaneous plastyma coli muscle flap. Rev Laryngol Otol Rhinol. 2009;130(3):139-144.
[25]. Harpf, C. Papp, H. Maurer. J. Thurner. Reconstruction of the lower lip with the myocutaneous platysma flap. Eur J Plast Surg 1992;15:296-299.
https://doi.org/10.1007/BF00212185
[26]. Posnick JC. McCraw JB. Reconstruction of the chin-lower cheek complex with a platysma myocutaneous flap. Journal of Oral & Maxillofacial Surgery. 1988; 46(2):152-5.
https://doi.org/10.1016/0278-2391(88)90270-4
PMid:3422282
