Direct Necklift for Men

Aims and Background Direct cervicoplasty remains a valuable alternative to rhytidectomy in male patients, addressing cervical laxity and fullness while avoiding feminization, peri-auricular scars, and prolonged recovery associated with traditional rhytidectomy. Historical Aspects Since the early 20th century, submental skin excision has undergone refinement, progressing from horizontal ellipses to advanced configurations such as the Grecian urn pattern. These modifications aim to optimize scar camouflage while correcting horizontal and vertical redundancy. Anatomy Key anatomic contributors to cervical aging include skin and platysmal laxity, supra-and sub-platysmal fat, anterior belly of the digastric hypertrophy, ptotic submandibular glands, and a low lying hyoid. Comprehensive preoperative analysis is required to address these factors. Patient Selection For patients presenting with submental fullness accompanied by good skin elasticity and minimal skin laxity, an isolated deep structural neck lift without skin excision may be sufficient. Optimal candidates for direct cervicoplasty demonstrate good elasticity, submental laxity limited to above the thyroid cartilage, minimal jowling, and acceptance of an anterior cervical scar. Techniques The isolated deep structural neck lift without skin excision is an excellent technique for patients with submental fullnes, good skin elasticity, and minimal skin laxity. A direct cervicoplasty with skin excision affords wide exposure for addressing the skin, platysma, and the sub-platysmal anatomy. Skin excision patterns are varied and tailored to the patient’s needs. Postoperative Care Scar modulation strategies, drain management, lymphatic assistance with positioning/ massage, and salivary flow management are key to a hastened recovery. Conclusions and Clinical Relevance Direct cervicoplasty remains an essential tool in the aging male patient, offering reproducible results in appropriately selected patients who are willing to accept its limitations.

Publikationsverlauf

Eingereicht: 21. September 2025

Angenommen: 23. September 2025

Accepted Manuscript online:
24. September 2025