Surgical Protocol
Step by Step
Complete protocol in 10 steps. Average time: 90-120 minutes.
90-120
Minutes
10
Steps
Local
+ Sedation
01
10min
Marking & Infiltration
Submental marking, tumescent infiltration
02
5min
Submental Incision
~3-4cm incision in submental crease
03
10min
Subcutaneous Dissection
Dissection until platysma visualization
04
5min
Platysma Opening
Midline incision for deep plane access
05
15min
Deep Fat Removal
Inter and subplatysmal fat cleaning until digastric visible
06
10min
Digastric Shaving
50-60% reduction of anterior belly if hypertrophied
07
5min
Pre-hyoid Fasciotomy
Horizontal section of fascia above hyoid
08
10min
Platysmorraphy
Medial platysma suture from mandible to hyoid
09
10min
Lateral Crevassi
Platysma fixation to SCM fascia bilaterally
10
10min
Closure
Layered suture, drain if needed
Critical Tips
Fat limit: Remove from hyoid upward. Preserve below hyoid.
Shaving: 50-60% of belly. Never plicate digastric tendon.
Fasciotomy: Mandatory in 100% of heavy neck cases.