What are your overall thoughts on this article?

I think it's a great article because if you have seen that deformity and you are trying to fix it, as they said, you know, if you're doing fatty grafting, it will require more than one session, which can be exhausting for the patient.

Using the ADM as it showed in these 25 patients that it is a viable solution.

which makes sense because when you have scarring anywhere, whether it is you have that attachment, that scarring where the skin is dimpling, if you release the scar without putting something to fill that space, it's always going to come back.

Like you see it in the facelift with the mandibular ligament.

If you just release it and you don't put fat in there, you turn in a fat flap or something in there, it's going to come back.

or you do fatty grafting, anytime you have that type of scar, if you don't fill the space, it's going to come back.

What characteristics make you most concerned that a patient will develop this deformity, thin periolar tissue, postpartum atrophy, the number of previous operations, implant size, repeated use of the incision, and when would you recommend someone abandoning the peri-areolar approach altogether in favor of a new inframammary incision?

So it's very interesting applying that to more aesthetic surgery.

Yeah, there are a lot of newer techniques that I'm not sure that they will at some point show the difference like the Z-plasty Francisco Bravo does with the deep plane, deep neck, when they are totally transacting the platysma and actually moving the upper part and the lower part.

So it's a Z-plasty, so the platysma is totally separated with the transaction of the descending branch of the cervical branch of the facial nerve.

I'm wondering if like now we are doing more and more deep neck, whether we are taking some of those minor innervations immediately, like when we are taking the gland out and we are opening the space above the strap muscles, whether taking, we know that there are some branches there.

I don't know if in the long run, this will show that.

when you compare the newer techniques, especially the deep neck ones, that they will have a significant change.

I don't know yet.

Dr. Cassis, do you agree with the author's central premise that persistent innervation and re-innervation rather than simply inadequate glycation or muscle regeneration is the main driver of recurrent platysmal bands?

So it's very interesting applying that to more aesthetic surgery.

Yeah, there are a lot of newer techniques that I'm not sure that they will at some point show the difference like the Z-plasty Francisco Bravo does with the deep plane, deep neck, when they are totally transecting the platysma and actually moving the upper part laterally and the lower part.

So it's a Z-plasty, so the platysma is totally separated.

With the transection of the descending branch of the cervical branch of the facial nerve, I'm wondering if like now we are doing more and more deep neck, whether we are taking some of those minor innervations medially, like when we are taking the gland out and we are opening the space above the strap muscles, whether taking, we know that there are some branches there.

I don't know if in the long run, this will show that when you compare the newer techniques, especially the deep neck ones that they will have, a significant change.

I don't know yet.

There is no evidence for it or not.

What are your overall thoughts on this article?