Drag The Appropriate Labels To Their Respective Targets. Platysma

The platysma, a broad sheet of muscle arising from the chest and shoulder, extends all the way up the neck, contributing to facial expressions and neck movements. Understanding its anatomy and function is crucial for medical professionals, cosmetic surgeons, and anyone interested in the intricate workings of the human body. This article will delve into the platysma muscle, covering its origin, insertion, innervation, blood supply, functions, clinical significance, and its importance in cosmetic procedures.

Anatomy of the Platysma Muscle

The platysma is a superficial muscle located in the anterior (front) region of the neck. It is one of the muscles of facial expression, even though it is located in the neck. It is a thin, flat muscle that covers the anterior and lateral aspects of the neck. Let's explore the various anatomical aspects:

Origin and Insertion

• Origin: The platysma originates from the fascia covering the superior parts of the pectoralis major and deltoid muscles. These muscles are located in the chest and shoulder, respectively.
• Course: From its origin, the platysma muscle fibers ascend superomedially (upward and inward) across the clavicle (collarbone) and towards the neck.
• Insertion: The platysma inserts into several locations:
  • Mandible: Some fibers insert into the inferior border of the mandible (jawbone).
  • Skin of the Lower Face: Many fibers insert into the skin and subcutaneous tissue of the lower part of the face, particularly around the mouth and cheek.
  • Muscles Around the Mouth: Some fibers blend with the muscles that control facial expressions around the mouth, such as the orbicularis oris (muscle around the mouth) and the depressor anguli oris (muscle that pulls down the corner of the mouth).

Structure and Appearance

The platysma is a thin, broad sheet of muscle. It is not always well-defined in all individuals, and its thickness can vary. The muscle fibers run in a superomedial direction, creating a noticeable appearance when the muscle is contracted. Subcutaneous fat can obscure the muscle's outline, but in some individuals, particularly those with less subcutaneous fat, the platysma is more visible.

Innervation

The platysma is innervated by the cervical branch of the facial nerve (CN VII). The facial nerve is responsible for controlling the muscles of facial expression, and the cervical branch specifically innervates the platysma. This innervation allows the platysma to contract and contribute to facial expressions. Damage to the cervical branch of the facial nerve can result in paralysis or weakness of the platysma muscle.

Blood Supply

The platysma receives its blood supply from branches of the submental artery and the suprascapular artery. These arteries provide the necessary oxygen and nutrients for the muscle to function properly. The submental artery is a branch of the facial artery, while the suprascapular artery arises from the thyrocervical trunk. Venous drainage typically follows the arterial supply, with blood draining into nearby veins.

Relationship to Other Structures

The platysma is a superficial muscle, meaning it lies just beneath the skin and subcutaneous tissue. It is located anterior to the sternocleidomastoid muscle (a major neck muscle involved in head movements) and superficial to deeper neck structures like the anterior jugular vein. The platysma overlies the external jugular vein as it descends in the neck.

Variations

Variations in the platysma muscle can occur between individuals. Some people may have a more developed or extensive platysma than others. The degree to which the platysma inserts into the mandible, skin, and muscles around the mouth can also vary. These variations can affect the appearance and function of the platysma muscle.

Functions of the Platysma Muscle

The platysma muscle serves several important functions related to facial expression, neck movement, and support. Its actions are subtle but contribute significantly to overall facial aesthetics and function.

Facial Expression

• Tension of the Skin of the Neck: The primary function of the platysma is to tense the skin of the neck. When the muscle contracts, it pulls the skin upward, reducing wrinkles and creating a smoother appearance. This action is particularly noticeable during certain facial expressions and movements.
• Depression of the Mandible: The platysma can assist in depressing the mandible, helping to open the mouth. This action is not as strong as that of the primary muscles of mastication (chewing), such as the masseter and temporalis, but it does contribute to jaw movement.
• Pulling Down the Corner of the Mouth: The platysma can pull down the corner of the mouth, contributing to expressions of sadness, disgust, or surprise. This action is achieved through its insertion into the muscles around the mouth.
• Expression of Stress or Fright: The platysma is often activated during times of stress, fright, or strong emotion. Its contraction can create vertical ridges on the neck, sometimes referred to as "platysmal bands," which are a visible sign of tension.

Neck Support

• Support for Skin and Subcutaneous Tissue: By providing tension to the skin of the neck, the platysma helps support the skin and subcutaneous tissue, preventing sagging and maintaining a more youthful appearance. This support is crucial for maintaining the contour of the neck and jawline.

Other Functions

• Protection of Underlying Structures: The platysma provides a layer of protection for the underlying structures in the neck, such as blood vessels and nerves. Although it is a thin muscle, it offers some degree of cushioning and support.

Clinical Significance

The platysma muscle holds clinical significance in various medical and surgical contexts. Its involvement in facial expression and neck aesthetics makes it relevant in fields such as neurology, cosmetic surgery, and reconstructive surgery.

Platysma Bands

• Definition: Platysma bands are vertical cords or ridges that appear on the neck due to the contraction of the platysma muscle. These bands become more prominent with age as the skin loses elasticity and the muscle becomes more active.
• Causes: Platysma bands are primarily caused by the natural aging process, which leads to a loss of collagen and elastin in the skin. Other factors that can contribute to platysma bands include genetics, sun exposure, and repetitive muscle movements.
• Treatment: Various treatments are available to address platysma bands, including:
  • Botulinum Toxin (Botox) Injections: Botox injections are a common treatment for platysma bands. The botulinum toxin temporarily paralyzes the platysma muscle, reducing its contraction and diminishing the appearance of the bands.
  • Platysmaplasty: Platysmaplasty is a surgical procedure that involves tightening or removing a portion of the platysma muscle. This procedure can provide a more long-lasting solution for platysma bands but carries the risks associated with surgery.
  • Dermal Fillers: Dermal fillers can be used to fill in the areas around the platysma bands, creating a smoother and more youthful appearance.
  • Radiofrequency and Ultrasound Treatments: These non-invasive treatments can stimulate collagen production in the skin, improving its elasticity and reducing the prominence of platysma bands.

Cervical Dystonia

• Definition: Cervical dystonia, also known as spasmodic torticollis, is a neurological disorder characterized by involuntary contractions of the neck muscles. These contractions can cause the head to twist or turn in an abnormal position.
• Involvement of the Platysma: The platysma muscle can be involved in cervical dystonia, contributing to the abnormal movements and postures of the head and neck.
• Treatment: Treatment for cervical dystonia may include:
  • Botulinum Toxin (Botox) Injections: Botox injections are often used to treat cervical dystonia by paralyzing the affected muscles, including the platysma. This can help reduce the involuntary contractions and improve the patient's posture and comfort.
  • Physical Therapy: Physical therapy can help improve range of motion and reduce muscle stiffness in the neck.
  • Medications: Certain medications, such as muscle relaxants and anticholinergics, may be used to manage the symptoms of cervical dystonia.
  • Deep Brain Stimulation: In severe cases, deep brain stimulation may be considered. This involves implanting electrodes in the brain to regulate the abnormal brain activity that causes cervical dystonia.

Facial Nerve Palsy

• Definition: Facial nerve palsy is a condition characterized by weakness or paralysis of the muscles on one side of the face. This can be caused by damage to the facial nerve (CN VII).
• Involvement of the Platysma: Because the platysma is innervated by the cervical branch of the facial nerve, facial nerve palsy can affect the function of the platysma muscle. This can result in a loss of muscle tone and decreased ability to tense the skin of the neck on the affected side.
• Symptoms: Symptoms of facial nerve palsy can include:
  • Drooping of the Face: The affected side of the face may droop, making it difficult to smile or close the eye.
  • Difficulty with Facial Expressions: Individuals with facial nerve palsy may have difficulty making facial expressions, such as frowning or raising the eyebrows.
  • Speech Difficulties: In some cases, facial nerve palsy can affect speech, making it difficult to pronounce certain words.
  • Dry Eye: Because the facial nerve controls the muscles that close the eye, facial nerve palsy can lead to dry eye.
• Treatment: Treatment for facial nerve palsy depends on the underlying cause and may include:
  • Medications: Corticosteroids may be used to reduce inflammation of the facial nerve.
  • Physical Therapy: Physical therapy can help strengthen the facial muscles and improve range of motion.
  • Surgery: In some cases, surgery may be necessary to repair or reconstruct the facial nerve.

Surgical Procedures

• Neck Lift (Platysmaplasty): Platysmaplasty is a surgical procedure designed to improve the appearance of the neck. It often involves tightening or removing a portion of the platysma muscle to reduce platysma bands and improve the contour of the neck.
• Facelift: During a facelift, the platysma muscle may be tightened or repositioned to improve the overall appearance of the lower face and neck.
• Reconstructive Surgery: The platysma muscle can be used in reconstructive surgery to provide coverage and support for damaged or missing tissue in the neck and face.

Platysma in Cosmetic Procedures

The platysma muscle is a significant focus in cosmetic procedures aimed at rejuvenating the neck and lower face. Understanding its anatomy and function is essential for achieving optimal results in these procedures.

Botulinum Toxin (Botox) Injections

• Mechanism of Action: Botox injections work by blocking the release of acetylcholine, a neurotransmitter that signals muscle contractions. By injecting Botox into the platysma muscle, the muscle is temporarily paralyzed, reducing its contraction and diminishing the appearance of platysma bands.
• Procedure: The procedure involves injecting small doses of Botox into specific points along the platysma muscle. The injections are typically quick and relatively painless.
• Results: The results of Botox injections for platysma bands are usually visible within a few days and can last for several months. The treatment can effectively reduce the appearance of platysma bands and create a smoother, more youthful-looking neck.
• Risks and Side Effects: Common side effects of Botox injections include:
  • Bruising: Bruising at the injection site is a common side effect.
  • Swelling: Swelling may occur at the injection site.
  • Neck Weakness: In some cases, Botox injections can cause temporary neck weakness or difficulty swallowing.
  • Asymmetry: Asymmetry in the results can occur if the Botox is not injected evenly.

Platysmaplasty

• Mechanism of Action: Platysmaplasty involves surgically tightening or removing a portion of the platysma muscle. This can be done through various techniques, such as:
  • Medial Platysmaplasty: This involves tightening the platysma muscle in the midline of the neck.
  • Lateral Platysmaplasty: This involves tightening the platysma muscle along the sides of the neck.
  • Platysma Resection: This involves removing a portion of the platysma muscle.
• Procedure: Platysmaplasty is typically performed under general anesthesia or local anesthesia with sedation. The surgeon makes incisions in the neck, tightens or removes the platysma muscle, and then closes the incisions.
• Results: Platysmaplasty can provide long-lasting results in improving the appearance of the neck. The procedure can reduce platysma bands, tighten loose skin, and improve the contour of the neck and jawline.
• Risks and Side Effects: Risks and side effects of platysmaplasty can include:
  • Bleeding: Bleeding is a risk associated with any surgical procedure.
  • Infection: Infection can occur at the incision site.
  • Scarring: Scarring is a potential side effect of platysmaplasty.
  • Nerve Damage: Nerve damage can occur during the procedure, leading to numbness or weakness in the neck.
  • Asymmetry: Asymmetry in the results can occur if the platysma muscle is not tightened or removed evenly.

Combination Treatments

• Combining Botox and Platysmaplasty: In some cases, Botox injections and platysmaplasty may be combined to achieve optimal results. Botox injections can be used to relax the platysma muscle before surgery, making it easier to tighten or remove the muscle.
• Combining Platysmaplasty with Other Procedures: Platysmaplasty is often combined with other cosmetic procedures, such as facelift, neck lift, and liposuction, to achieve a more comprehensive rejuvenation of the face and neck.

Exercises for the Platysma Muscle

While the platysma is not a muscle that can be significantly strengthened through exercise, certain exercises can help improve its tone and reduce the appearance of platysma bands.

Platysma Toning Exercises

• Jaw Thrust:
  • Sit or stand with your head facing forward.
  • Thrust your lower jaw forward, as if you are trying to create an underbite.
  • Hold the position for a few seconds, feeling the tension in your neck muscles.
  • Repeat this exercise several times.
• Lip Press:
  • Press your lips together tightly, as if you are trying to prevent something from escaping your mouth.
  • Hold the position for a few seconds, feeling the tension in your neck muscles.
  • Repeat this exercise several times.
• Neck Extension:
  • Tilt your head back, looking up at the ceiling.
  • Press your tongue against the roof of your mouth, feeling the tension in your neck muscles.
  • Hold the position for a few seconds.
  • Repeat this exercise several times.

Facial Yoga

Facial yoga involves a series of exercises designed to tone and strengthen the facial muscles, including the platysma. These exercises can help improve the appearance of the neck and reduce the signs of aging.

Conclusion

The platysma muscle, though often overlooked, plays a crucial role in facial expression, neck support, and overall aesthetics. Its origin from the chest and shoulder, insertion into the mandible and facial muscles, and innervation by the facial nerve make it an intricate part of the human anatomy. Clinically, the platysma is significant in conditions like platysma bands, cervical dystonia, and facial nerve palsy, and it is a key focus in cosmetic procedures such as Botox injections and platysmaplasty. By understanding the anatomy, function, and clinical relevance of the platysma, medical professionals and individuals alike can appreciate its importance in maintaining facial aesthetics and function.