Foundations

Applied Cervical Anatomy

The layers and noble structures you need to master.

In the neck, the SMAS equivalent is the platysma. Just as we work in the sub-SMAS plane in the face, in the neck we work in the subplatysmal plane.

Neck Layers

StructureDepthDescription
SkinSuperficialExternal coverage
Subcutaneous FatSuperficialVariable by biotype
PlatysmaSuperficialThin muscle, cervical equivalent of SMAS
Subplatysmal FatDeepMain Deep Neck target
DigastricDeepAnterior belly - heavy neck villain
MylohyoidDeepCentral floor
Deep Cervical FasciaDeepFasciotomy target
Submandibular GlandDeepNEVER removed

Noble Structures

Marginal Nerve

Location: Mandibular border

Risk: Lip paralysis

Protection: Avoid deep proximal dissection

External Jugular

Location: Lateral over SCM

Risk: Bleeding

Protection: Identify and preserve

Facial Artery/Vein

Location: Near gland

Risk: Bleeding

Protection: Don't touch gland

Wharton's Duct

Location: Near gland

Risk: Sialocele

Protection: Don't touch gland