Isolated Management of the Aging Neck
16 November 2009 (online)
The contour of the neck is a very important determinant of facial aesthetics. Precise knowledge of neck anatomy is essential for adequate planning and execution of this procedure. There are three anatomic and surgical planes involved in the management of the aging neck; the superficial plane (subcutaneous fat), the intermediate plane (platysma muscles and the fat between the two muscles), and the deep plane (subplatysmal fat, the anterior belly of the digastric muscles, and the submandibular glands). These planes need to be thoroughly evaluated in the preoperative assessment and dealt with according to each patient's needs. Even though this article focuses on isolated management of the aging neck, careful evaluation of the neck and its relationship to the lower third of the face is fundamental. If there is significant jowling and descent of the neck-face interface, an isolated neck-lift procedure will not address that problem and will lead to a suboptimal result. In these patients, a face and neck lift is a more appropriate operation.
Neck lift - cervicomental angle - platysma - SMAS
- 1 Nahai F.
Neck lift. In: Nahai F The Art of Aesthetic Surgery. St. Louis, MO; Quality Medical Publishing 2005: 1239-1283
- 2 Connell B F, Shamoun J M. The significance of digastric muscle contouring for rejuvenation of the submental area of the face. Plast Reconstr Surg. 1997; 99 1586-1590
- 3 Ellenbogen R, Karlin J V. Visual criteria for success in restoring the youthful neck. Plast Reconstr Surg. 1980; 66 826-837
- 4 Nahai F, Nahai F R, Ford D T.
Applied anatomy of the face and neck. In: Nahai F The Art of Aesthetic Surgery. St. Louis, MO; Quality Medical Publishing 2005: 827-896
- 5 Nahai F, Bryce A.
Deep plane procedures in the neck. In: Aston SJ, Steinbrech D, Walden J Aesthetic Plastic Surgery. New York; Elsevier 2009: 231-242
- 6 Feldman J J. Corset platysmaplasty. Plast Reconstr Surg. 1990; 85 333-343
- 7 Fuente del Campo A. Midline platysma muscular overlap for neck restoration. Plast Reconstr Surg. 1998; 102 1710-1714 discussion 1715
- 8 Guerrerosantos J. Neck lift. Simplified surgical technique, refinements, and clinical classification. Clin Plast Surg. 1983; 10 379-404
- 9 Nahai F. Reconsidering neck suspension sutures. Aesthet Surg J. 2004; 24 365-367
Farzad R Nahai, M.D.
Paces Plastic Surgery, 3200 Downwood Circle
NW, Suite 640, Atlanta, GA 30327