Platysmacutaneous ligaments: anchoring the platysma to skin

The platysmacutaneous ligaments are bands of fibrous tissue that bridge the platysma (and the superficial fibromuscular layer) and the skin. They do not form a single visible cord: they work as a network of anchors that keeps the skin of the lower third and the neck tied to the deep plane at specific points.

Where do they appear in the anatomy?

The group most often mentioned in orofacial harmonization (HOF) lies along the edge of the mandible, in the region where the face passes into the neck. There, the mandibular ligament is the classic reference, and the platysmacutaneous ligaments add to it and to the other retaining ligaments. In the neck, similar fibers anchor the skin to the platysma and contribute to folds and the look of platysmal bands.

When the surrounding tissue loses firmness, the skin stays anchored at these points and the rest descends. This contrast creates depressions and bulges that the patient describes as "sagging".

Why does this matter in the assessment?

The jowl is the best-known example: the skin stays fixed at one point of the mandible, and fat and soft tissue gather in front of and below that point. The same reasoning explains part of the double chin and the lines that run down from the corner of the mouth.

Understanding the anchoring changes the conversation with the patient. Instead of saying that volume is "missing" everywhere, the professional can show that the problem is the relationship between anchored and loose areas, and that the approach should respect that mechanics.

How does this fit with planning?

When reading the lower third, it is worth observing three things before talking about volume:

• where the skin seems anchored (marks and depressions that do not change with expression);
• where tissue accumulates above and below the jawline;
• whether the contour improves standing, lying down, or with the head slightly raised.

This last test helps separate laxity from true ptosis. The decision to use filler in the jawline, collagen stimulators, threads, or another approach rests with the qualified professional, after assessment, and depends on skin, fat, bone, and expectations.

In Harmy

The Jawline point of the marking represents filler along the jawline. Ligaments have no marking of their own: the projection changes only the marked areas, with the volume in ml entered, always as an illustrative simulation.

Also called: cutaneous ligaments of the platysma, platysmacutaneous anchors.