Step 1 Preparation and Draping

Pertinent landmarks useful during dissection should be exposed throughout the surgical procedure. When the rhytidectomy approach to the mandible ramus/angle is used, the structures that should be visible in the field include the corner of the eye, the corner of the mouth, and the lower lip anteriorly; and the entire ear and descending hairline, as well as 2 to 3 cm of hair superior to the posterior hairline, posteriorly. The temporal area must also be completely exposed. Inferiorly, several centimeters of skin below the inferior border of the mandible are exposed to provide access for undermining the skin. Shaving the sideburns and temporal hair is unnecessary, except from a convenience standpoint.

Figure 11- 1 Anatomic dissection showing the relationship of the great auricular nerve (*) to the sternocleidomastoid muscle (SCM) and ear.

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