All tissue between the lower border of the mandible and the clavicle and between the anterior edge of the trapezius and the anterior midline is taken from the underside of the platysma to the deep muscular fascia. The carotids, brachial plexus, phrenic and vagus nerves are normally preserved except when directly invaded.
The investing layer of cervical fascia (incorporating sternocleidomastoid and trapezius muscles) is exposed to the limits of the dissection along with jugular vein branches and cervical plexus nerves. The marginal mandibular branch of the facial nerve may or may not be visualized along the edge of the mandible beneath the upper flap.
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