Surgical Management of the Aging Neck

ABSTRACT

Blunting of the cervicomental angle with age is caused by progressive laxity of the skin and subcutaneous tissues, along with proliferation of fatty deposits and platysma muscle banding. This contributes to a loss of the slender neckline associated with youth, often a primary point of concern for patients. Surgeons may avail themselves of several surgical techniques in common use to restore definition to this region. A thorough evaluation of bone and soft tissue anatomy informs the appropriate surgical approach and allows successful rejuvenation of the aging neck. The lead author’s tactics for enhancement of the neck are outlined.

KEYWORDS

Neck lift - submentoplasty - cervicoplasty - platysmaplasty - rhytidectomy - liposuction

REFERENCES

• 1 Wall S J, Adamson P A. Surgical options for aesthetic enhancement of the neck.  Facial Plast Surg. 2001;  17 109-115
• 2 Dedo D D. A preoperative classification of the neck for cervicofacial rhytidectomy.  Laryngoscope. 1980;  90 1894-1896
• 3 Kamer F M, Minoli J J. Postoperative platysmal band deformity. A pitfall of submental liposuction.  Arch Otolaryngol Head Neck Surg. 1993;  119 193-196
• 4 Bourguet J. La disparition chiurgicale des rides et plis du visage.  Bull Acad Med (Paris). 1919;  82 183
• 5 Fischer G. Liposculpture: the “correct” history of liposuction. Part I.  J Dermatol Surg Oncol. 1990;  16 1087-1089
• 6 Gross C W, Becker D G, Lindsey W H, Park S S, Marshall D D. The soft-tissue shaving procedure for removal of adipose tissue. A new, less traumatic approach than liposuction.  Arch Otolaryngol Head Neck Surg. 1995;  121 1117-1120
• 7 Adamson P A, Cormier R, Tropper G J, McGraw B L. Cervicofacial liposuction: results and controversies.  J Otolaryngol. 1990;  19 267-273
• 8 Hull M J, Smith R L. The retrognathic mandible-surgical correction.  Oral Surg Oral Med Oral Pathol. 1976;  41 2-17
• 9 Stanton D C. Genioplasty.  Facial Plast Surg. 2003;  19 75-86
• 10 Conrad K, Chapnik J S, Reifen E. e-PTFE (Gore-Tex) suspension cervical facial rhytidectomy.  Arch Otolaryngol Head Neck Surg. 1993;  119 694-698
• 11 Prabhat A, Dyer II W K. Improving surgery on the aging neck with an adjustable expanded polytetrafluoroethylene cervical sling.  Arch Facial Plast Surg. 2003;  5 491-501
• 12 Cannon B, Pantazelos H H. W-plasty approach to submandibular lipectomy. In: Hueston JD Transactions of the Fifth International Congress of Plastic and Reconstructive Surgery Woburn; Butterworths 1970: 1113-1117
• 13 Cronin T D, Biggs T M. The T-Z-plasty for the male “turkey gobbler” neck.  Plast Reconstr Surg. 1971;  47 534-538
• 14 Ehlert T K, Thomas J R, Becker Jr F F. Submental W-plasty for correction of ‘turkey gobbler’ deformities.  Arch Otolaryngol Head Neck Surg. 1990;  116 714-717
• 15 Adamson P A, Smith O D. Revision of a vertical tracheotomy scar using the W-plasty technique.  J Otolaryngol. 1989;  18 362-364
• 16 Borges A F. Improvement of antitension line scar by the W-plastic operation.  Br J Plast Surg. 1959;  12 12-29