The author updates prior descriptions of an approach to the surgical neck lift that aims for a maximum degree of control over the size, shape, and position of every anatomical feature of the neck that is negatively affecting its appearance.
A 38-year clinical experience guided the development of the operative tactics that define the strategy. Data collected from a records review of 522 consecutive neck lifts performed during the 10-year period 2004 through 2013 further inform the report. The approach has eight features: (1) nearly routine use of open submental access to all tissue layers of the central neck, including a regimen that curbed the problems that may attend an extensive tissue dissection; (2) management of lax neck skin by lateral excision using a specific postauricular incision, or by using the nonexcisional method of redistribution; (3) open lipectomy for precise removal of excess subcutaneous neck and jawline fat; (4) individualized modifications to subplatysmal fat, perihyoid fascia, and anterior digastric muscles; (5) treatment of large, ptotic, or malpositioned submandibular salivary glands by partial excision using a transcutaneous traction suture; (6) the current version of the corset platysmaplasty, which is used to treat static paramedian platysma muscle bands, and to avoid contour imperfections following subplatysmal maneuvers; (7) an approach that facilitates an isolated neck lift; and (8) durable results.
Case examples demonstrate outcomes.
Although the updated approach remains relatively complex and invasive, the author believes that the ends justify the means.
Cambridge and Boston, Mass.
From private practice, and the Department of Surgery, Harvard Medical School.
Received for publication January 9, 2014; accepted March 26, 2014.
Disclosure: The author has no commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article. No funding was received for the work presented in this article. The author does receive royalties on the sale of a book entitled Neck Lift published by Quality Medical Publishing, Inc.
Joel J. Feldman, M.D., Medical Office Building, Suite 304, 300 Mt. Auburn Street, Cambridge, Mass. 02138, email@example.com