Abstract
A well-contoured neck is an artistic imperative to an attractive and appealing appearance.
A good neckline conveys a sense of youth, health, fitness, confidence, and vitality
and lends an appearance of decisiveness, sensuality, and beauty. Neck improvement
is of high priority to almost every patient seeking facial improvement, and the results
of “face lift” procedures are judged largely by the outcome obtained in the neck.
If the neck is not sufficiently improved, our patients will often feel we have failed
them. Despite the fact that it is a common practice, it is not enough to perform submental
liposuction and tighten the skin and platysma in most patients as such an approach
ignores a number of anatomical problems present in many patients seeking neck improvement
including excess subplatysmal fat, large submandibular glands, and digastric muscle
hypertrophy and malposition. Removing subcutaneous fat and tightening skin and platysma
over these problems does not correct them, and the presence or absence of each must
be looked for in order to create and apply an appropriate surgical plan. Success or
failure in treating the neck lies in the diagnosis of underlying problems and the
application of a logical surgical plan to correct them. Any surgeon capable of identifying
the anatomic basis of patient problems and forming a sound plan for their correction
will achieve excellent outcomes.
Keywords
neck lift - short scar neck lift - submandibular gland reduction - partial digastric
myectomy - subplatysmal fat
