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Neck Lift My Way: An Update

Feldman, Joel J. M.D.

Plastic and Reconstructive Surgery: December 2014 - Volume 134 - Issue 6 - p 1173–1183
doi: 10.1097/PRS.0000000000000712
Cosmetic: Original Articles
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Background: 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.

Methods: 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.

Results: Case examples demonstrate outcomes.

Conclusion: Although the updated approach remains relatively complex and invasive, the author believes that the ends justify the means.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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, jjf@drjoelfeldman.com

©2014American Society of Plastic Surgeons