Surgical alteration of the platysma muscle improves the results of cervicofacial rhytidoplasty. The operative technique indicated for an individual patient is determined, in part, by the anatomy of the platysma deformity. Many questions regarding the late results of platysma muscle surgery can only be answered by long-term follow-up. This paper presents the results in 75 patients who had platysma muscle flap cervicofacial rhytidoplasty. The 8 most common platysma deformities are discussed. Undesirable results and pitfalls in technique are noted.