Step 6 Closure

The masseter and medial pterygoid muscles are sutures together with interrupt resorbable sutures. It may be difficult to pass the suture needle through the medial pterygoid muscle because it is very thin at the inferior and posterior borders of the mandible. To facilitate closure, the edge of the medial pterygoid muscle can be stripped for easier needle passage.

Closure of the parotid capsule/SMAS and platysma layer is important to avoid salivary fistula. A running, slowly resorbing horizontal mattress suture is used to tightly close the parotid capsule, SMAS, and platysma muscle in one watertight layer. Placement of subcutaneous sutures is followed by skin closure.

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