Novel Classifications for Muscular Contraction of the Lower Face and Neck

BACKGROUND Currently, there are no scales that address lower-face muscular contraction patterns, and there is only one that addresses platysmal bands. OBJECTIVE The goal of this article is to create scales to classify the strength and contraction patterns of the lower face and neck based on (1) the muscular anatomy and contraction patterns of the platysma and (2) the strength of the depressor anguli oris (DAO). METHODS Three hundred sixty patients participated in the study. Standardized photogarphs were taken in an effort to characterize muscle contraction patterns. RESULTS A novel classification measuring the strength of the DAO is presented. For the DAO, 4 different contraction patterns were observed: Type 1 (38%), Type 0 (26.3%), Type 2 (25.2%), and Type 3 (8.6%). The remainder (1.9%) used asymmetric contraction. For platysmal bands, 3 different contraction patterns were observed: complete contraction (64.53%), lateral contraction (19.83%), and central contraction pattern (11.73%). A small percentage of patients (3.91%) had an asymmetric contraction pattern. CONCLUSION Categorization of contraction of the DAO and platysmal bands into these proposed classifications provides objective measurements that can be helpful for designing treatment protocols and assessing response to treatment. Address correspondence and reprint requests to: Berta E. Alcalá, MD, Roger de flor 2907, 512 Las Condes, Santiago, Chile 7550201, or e-mail: berta.alcala@gmail.com The authors have indicated no significant interest with commercial supporters. B.S.F. Bravo is a speaker for Allergan. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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