The Functional Anatomy and Innervation of the Platysma is Segmental: Implications for Lower Lip Dysfunction, Recurrent Platysmal Bands, and Surgical Rejuvenation

Overview

The platysma is central to face and neck lifts, yet its surgical anatomy is debated. The authors mapped its attachments and nerve supply to explain why neck bands form and return and why the lower lip can weaken after a neck lift.

Findings

• 55 cadaver heads (16 embalmed, 39 fresh; mean age 75 years); layered dissection, histology, sheet plastination.
• Beyond its origin and insertion, the platysma is attached to the skin and deep fascia across its whole front and back surfaces.
• This attachment system explains age-related static platysmal bands, bands that return after complete platysma transection, and front-of-neck laxity that returns after lifting without release.
• The facial part of the platysma is supplied mainly by the marginal mandibular branch of the facial nerve.
• The part below the jaw is supplied by the "first" cervical branches, which end at the jaw origin of the depressor labii inferioris, a lower lip muscle.
• This nerve pattern bears on lower lip dysfunction after surgery, including pseudoparalysis, and on possible targeted denervation.

What it means for a patient

• Neck bands can come back after a neck lift, even after the muscle is cut, because the muscle is also attached to the skin and deeper tissue.
• Temporary lower lip weakness after neck lift can come from nerves in the neck, not only the main jaw-line nerve branch.
• Ask your surgeon how they treat the platysma to prevent bands from returning.
• This is a cadaver study. It explains anatomy but does not test surgical results in patients.

Why this paper matters

It maps the platysma's attachments and segmental nerve supply, including nerve danger zones. The authors present it as a basis for neck lift techniques that prevent recurrent banding. Cited 28 times (NIH iCite, 2026-09-25).

Terms

• Platysma: the thin, flat muscle over the front of the neck and lower face.
• Platysmal bands: vertical cords in the front of the neck formed by the edges of the platysma.
• Innervation: the nerve supply to a muscle.
• Marginal mandibular nerve: the facial nerve branch that runs along the jaw and moves the lower lip.
• Depressor labii inferioris: the muscle that pulls the lower lip down.
• Pseudoparalysis: lip weakness that looks like nerve injury but has another cause.
• Sheet plastination: a method that preserves thin slices of tissue in plastic so layers can be studied.