Optimizing Outcomes in Neck Lift Surgery
Abstract Background In certain patients there is an imbalance between the volume of the anterior neck and the mandibular confines that require reductional sculpting and repositioning of the hyoid to optimize neck lifting procedures. Objectives A quantitative volumetric analysis of impact of the management of supraplatysmal and subplatysmal structures of the neck by comparing surgical specimen was performed to determine the impact of reduction on cervical contouring. Methods In 152 patients undergoing deep cervicoplasty, the frequency of modification of each surgical maneuver and amount of supraplatysmal and subplatysmal volume removed was measured in cubic centimeters using a volume displacement technique. Results The mean volume of total volume remove from the supraplatysmal and subplatysmal planes during deep cervicoplasty was 22.3 cm3 with subplatysmal volume representing 73%. Subplatysmal volume was reduced in 152 patients. Deep fat was reduced in 96% of patients with mean volume of 7 cm3, submandibular glands (76%) with mean volume 6.5cm, anterior digastric muscles (70%) with mean volume 2cm3, peri-hyoid fascia (32%) with mean volume <1cm3 and mylohyoid reduction (14%) with mean volume < 1cm3 in the series. The anterior digastric muscles were plicated to reposition the hyoid in 34% of cases. Supraplatysmal fat reduction was 6.3 cm3 in 40% of patients. Conclusions The study provides a comprehensive analysis of the impact of volume modification of the central neck during deep cervicoplasty. This objective evaluation of neck volume may help guide clinicians in the surgical planning process and provide a foundation for optimizing cervicofacial rejuvenation techniques.