Managing the Neck in the Era of the Short Scar Face-Lift

Fred G. Fedok; Jacob Sedgh

doi:10.1055/s-0032-1305791

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2012; 28(01): 60-75
DOI: 10.1055/s-0032-1305791

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Managing the Neck in the Era of the Short Scar Face-Lift

Fred G. Fedok

¹Facial Plastic and Reconstructive Surgery Unit, Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania

,

Jacob Sedgh

¹Facial Plastic and Reconstructive Surgery Unit, Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania

› Author Affiliations

Abstract

A recent trend in rhytidectomy has included the introduction of various short incision techniques, particularly the S-lift, the minimal access cranial suspension lift, and other short scar methods. However, this trend has not been without a criticism that these minimally invasive techniques might be limited in what might be achievable by such surgery. As with more traditional face-lift surgery, the management of the neck often presents as the most challenging aspect of the procedure when using short scar techniques. This article will present a brief history of cervical rhytidectomy and relevant surgical anatomy, as well as the authors' algorithmic approach to surgical assessment and management of the neck, the short incision operative techniques, and potential complications. In the authors' experience, attention to both the selection criteria and operative modifications in the execution of short scar techniques are critical to optimizing outcomes in cervical rejuvenation.

Keywords

SMAS: superficial musculoaponeurotic system - MACS: minimal access cranial suspension - short scar rhytidectomy - cervical rhytidectomy - neck-lift

Full Text

References

References
1 Michalany Filho S. Neck rhytidectomy: aesthetic treatment variations. Aesthetic Plast Surg 1997; 21: 32-37
2 Rogers BO. History of the Development of Aesthetic Surgery. In: Regnault P, Daniel RK, , eds. Aesthetic Plastic Surgery. Boston, MA/Toronto, Ontario, Canada: Little, Brown and Company; 1984
3 Marchac D. Julien Bourguet. The pioneer in aesthetic surgery of the neck. Clin Plast Surg 1983; 10: 363-365
4 Skoog TG. Plastic surgery: the aging face. In: Skoog TG, , ed. Plastic Surgery: New Methods and Refinements. Philadelphia, PA: W.B. Saunders; 1974
5 Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 1976; 58: 80-88
6 Olmedo A, Longato F. The case for full-width platysma transection and rotation. Aesthetic Plast Surg 2002; 26: 239-250
7 Connell BF. Contouring the neck in rhytidectomy by lipectomy and a muscle sling. Plast Reconstr Surg 1978; 61: 376-383
8 Dedo DD. “How I do it”—plastic surgery. Practical suggestions on facial plastic surgery. A preoperative classification of the neck for cervicofacial rhytidectomy. Laryngoscope 1980; 90 (11 Pt 1) 1894-1896
9 Ellenbogen R, Karlin JV. Visual criteria for success in restoring the youthful neck. Plast Reconstr Surg 1980; 66: 826-837
10 Feldman JJ. Corset platysmaplasty. Plast Reconstr Surg 1990; 85: 333-343
11 Hamra ST. Composite rhytidectomy. Plast Reconstr Surg 1992; 90: 1-13
12 McCurdy Jr JA. A rational approach to the neck in cervicofacial rhytidectomy—a guide to planning skin undermining, platysma surgery, and lipectomy. Laryngoscope 1984; 94: 1383-1384
13 Rohrich RJ, Rios JL, Smith PD, Gutowski KA. Neck rejuvenation revisited. Plast Reconstr Surg 2006; 118: 1251-1263
14 Labbé D, Franco RG, Nicolas J. Platysma suspension and platysmaplasty during neck lift: anatomical study and analysis of 30 cases. Plast Reconstr Surg 2006; 117: 2001-2007 ; discussion 2008–2010
15 Henley JL, Lesnik DJ, Terk AR. Contralateral platysma suspension: an adjunct to rhytidectomy. Arch Facial Plast Surg 2005; 7: 119-123
16 Baker DC. Minimal incision rhytidectomy (short scar face lift) with lateral SMASectomy: evolution and application. Aesthet Surg J 2001; 21: 14-26
17 Tonnard P, Verpaele A, Monstrey S , et al. Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 2002; 109: 2074-2086
18 Saylan Z. The S-lift: less is more. Aesthet Surg J 1999; 19: 406-409
19 Bhawan J, Andersen W, Lee J, Labadie R, Solares G. Photoaging versus intrinsic aging: a morphologic assessment of facial skin. J Cutan Pathol 1995; 22: 154-159
20 Kligman LH. Photoaging. Manifestations, prevention, and treatment. Dermatol Clin 1986; 4: 517-528
21 Williams III EF, Pontius AT. The aging neck. In: Bailey BJ, , ed. Head & Neck Surgery–Otolaryngology, 4th ed. Philadelphia, PA: Lippincott; 2006: 2651-2662
22 Dedo DD. The aging neck. In: Bailey BJ, , ed. Head & Neck Surgery–Otolaryngology, 2nd ed. Philadelphia, PA: Lippincott; 1998: 2717-2732
23 de Castro CC. The anatomy of the platysma muscle. Plast Reconstr Surg 1980; 66: 680-683
24 Furnas DW. The retaining ligaments of the cheek. Plast Reconstr Surg 1989; 83: 11-16
25 Labbe D, Nicolas J. The anatomic basis of platysma suspension. In: Tonnard PL, Verpaele AM, , eds. Short Scar Face Lift: Operative Strategies and Techniques. St. Louis, MO: Quality Medical Publishing; 2007: 237-269
26 Panfilov DE. Facelift-related anatomy. In: Panfilov DE, , ed. Aesthetic Surgery of the Facial Mosaic. Berlin, Germany: Springer; 2007: 52-65
27 Sherris DA, Larrabee Jr WF. Anatomic considerations in rhytidectomy. Facial Plast Surg 1996; 12: 215-222
28 Sykes JM. Rejuvenation of the aging neck. Facial Plast Surg 2001; 17: 99-107
29 Guyuron B. Problem neck, hyoid bone, and submental myotomy. Plast Reconstr Surg 1992; 90: 830-837 ; discussion 838–840
30 Gonzalez-Ulloa M. Quantitative principles in cosmetic surgery of the face (profileplasty). Plast Reconstr Surg Transplant Bull 1962; 29: 186-198
31 Koch RJ, Hanasono MM. Aesthetic facial analysis. In: Papel IR, , ed. Facial Plastic and Reconstructive Surgery, 2nd ed. New York, NY: Thieme Medical Publishers; 2002: 135-144
32 Connell BF. Cervical lifts: the value of platysma muscle flaps. Ann Plast Surg 1978; 1: 32-43
33 Giampapa VC, Di Bernardo BE. Neck recontouring with suture suspension and liposuction: an alternative for the early rhytidectomy candidate. Aesthetic Plast Surg 1995; 19: 217-223
34 Grotting JC, Beckenstein MS. Cervicofacial rejuvenation using ultrasound-assisted lipectomy. Plast Reconstr Surg 2001; 107: 847-855
35 Little JW. Plenary Session Panel: Lower Face. Presented at: AAFPRS Fall Meeting; September 19, 2007; Washington DC
36 Tonnard PL, Verpaele AM. Refining the MACS-lift technique and defining its limits. In: Tonnard PL, Verpaele AM, , eds. Short Scar Face Lift: Operative Strategies and Techniques. St. Louis, MO: Quality Medical Publishing; 2007: 115-182
37 Prado A, Andrades P, Danilla S, Castillo P, Leniz P. A clinical retrospective study comparing two short-scar face lifts: minimal access cranial suspension versus lateral SMASectomy. Plast Reconstr Surg 2006; 117: 1413-1425 ; discussion 1426–1427
38 Camirand A, Doucet J. A comparison between parallel hairline incisions and perpendicular incisions when performing a face lift. Plast Reconstr Surg 1997; 99: 10-15