Step 3 Skin Incision

The initial incision is carried through skin and subcutaneous tissues to the level of the platysma muscle (Fig. 9-4). The skin is undermined with scissor dissection in all directions to facilitate closure. The superior portion of the incision is undermined approximately 1 cm; the inferior portion is undermined approximately 2 cm or more. The ends of the incision can be undermined extensively to allow retraction of the skin anteriorly or posteriorly to increase the amount of mandibular exposure. In this manner, a shorter skin incision can provide a great amount of exposure. Hemostasis is then achieved with eletrocoagulation of bleeding subdermal vessels.

Submandibular Incision
Figure 9- 3 Two locations of submandibular incisions. Incision A parallels the inferior border of the mandible. Incision B parallels or is within the resulting skin tension lines. Incision B makes a less conspicuous scar in most patients.

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