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DOI: 10.1055/s-0041-1725167
Conservative Neck Rejuvenation
Funding None.![](https://www.thieme-connect.de/media/fps/202103/lookinside/thumbnails/10-1055-s-0041-1725167_200149or-1.jpg)
Abstract
In the field of facial rejuvenation, among the recurrent topics, one of the most discussed is the return to less invasive techniques. Lower face rejuvenation is best achieved acting on the platysma muscle. Many techniques are used and usually include platysma section, redundancy reduction, and redraping. Platysma plication is also used especially in secondary cases because of the increased risk of nerve injury due to possible anatomical damage caused by previous operations. A technique that preserves the deep planes based on a new plication method is proposed (conservative neck rejuvenation). In this technique, the dissection plane is only subcutaneous to reduce the risk of nerve injuries. An effective neck contouring is possible using a simpler technique with very good results and a lower rate of morbidity.
Publication History
Article published online:
11 March 2021
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References
- 1 American Society for Aesthetic Plastic Surgery. 2018 National plastic surgery statistics. Available at: https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-report-2018.pdf
- 2 Jacono AA, Malone MH, Lavin TJ. Nonsurgical facial rejuvenation procedures in patients under 50 prior to undergoing facelift: habits, costs, and results. Aesthet Surg J 2017; 37 (04) 448-453
- 3 Rohrich RJ, Narasimhan K. Long-term results in face lifting: observational results and evolution of technique. Plast Reconstr Surg 2016; 138 (01) 97-108
- 4 Liu TS, Owsley JQ. Long-term results of face lift surgery: patient photographs compared with patient satisfaction ratings. Plast Reconstr Surg 2012; 129 (01) 253-262
- 5 Charafeddine AH, Drake R, McBride J, Zins JE. Facelift: history and anatomy. Clin Plast Surg 2019; 46 (04) 505-513
- 6 Wan D, Dayan E, Rohrich RJ. Safety and adjuncts in face lifting. Plast Reconstr Surg 2019; 144 (03) 471e-484e
- 7 Floyd E, Perkins SW. The past, present and future of facial plastic and reconstructive surgery: facelift. Facial Plast Surg 2019; 35 (04) 353-357
- 8 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 (06) 2001-2007 , discussion 2008–2010
- 9 Fogli AL. Skin and platysma muscle anchoring. Aesthetic Plast Surg 2008; 32 (03) 531-541
- 10 Knize DM. Limited incision submental lipectomy and platysmaplasty. Plast Reconstr Surg 1998; 101 (02) 473-481
- 11 Feldman JJ. Neck Lift. St. Louis, MO: Quality Medical; 2007
- 12 Zins JE, Fardo D. The “anterior-only” approach to neck rejuvenation: an alternative to face lift surgery. Plast Reconstr Surg 2005; 115 (06) 1761-1768
- 13 Narasimhan K, Ramanadham S, O'Reilly E, Rohrich RJ. Secondary neck lift and the importance of midline platysmaplasty: review of 101 cases. Plast Reconstr Surg 2016; 137 (04) 667e-675e
- 14 Pelle-Ceravolo M, Angelini M, Silvi E. Complete platysma transection in neck rejuvenation: a critical appraisal. Plast Reconstr Surg 2016; 138 (04) 781-791
- 15 Batra AP, Mahajan A, Gupta K. Marginal mandibular branch of the facial nerve: an anatomical study. Indian J Plast Surg 2010; 43 (01) 60-64
- 16 Basar R, Sargon MF, Tekdemir Y, Elhan A. The marginal mandibular branch of the facial nerve. Surg Radiol Anat 1997; 19 (05) 311-314
- 17 Dingman RO, Grabb WC. Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves. Plast Reconstr Surg Transplant Bull 1962; 29: 266-272
- 18 Baker DC, Conley J. Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls. Plast Reconstr Surg 1979; 64 (06) 781-795
- 19 Baur DA, Kaiser AC, Leech BN, Landers MA, Altay MA, Quereshy F. The marginal mandibular nerve in relation to the inferior border of the mandible. J Oral Maxillofac Surg 2014; 72 (11) 2221-2226
- 20 Touré G, Tran de Fremicourt MK, Randriamanantena T, Vlavonou S, Priano V, Vacher C. Vascular and nerve relations of the marginal mandibular nerve of the face: anatomy and clinical relevance. Plast Reconstr Surg 2019; 143 (03) 888-899
- 21 Anthony DJ, Oshan Deshanjana Basnayake BM, Mathangasinghe Y, Malalasekera AP. Preserving the marginal mandibular branch of the facial nerve during submandibular region surgery: a cadaveric safety study. Patient Saf Surg 2018; 12: 23
- 22 Schwember G, Rodríguez A. Anatomic surgical dissection of the extraparotid portion of the facial nerve. Plast Reconstr Surg 1988; 81 (02) 183-188
- 23 Balagopal PG, George NA, Sebastian P. Anatomic variations of the marginal mandibular nerve. Indian J Surg Oncol 2012; 3 (01) 8-11
- 24 Stuzin JM, Rohrich RJ. Facial nerve danger zones. Plast Reconstr Surg 2020; 145 (01) 99-102
- 25 Mathew PC, Gouri BP, Sebastian P. et al. Anatomic variations of the marginal mandibular nerve. Int J Oral Maxillofac Surg 2007; 11: 1025
- 26 Kamer FM, Nguyen DB. Experience with fibrin glue in rhytidectomy. Plast Reconstr Surg 2007; 120 (04) 1045-1051 , discussion 1052
- 27 Grover R, Jones BM, Waterhouse N. The prevention of haematoma following rhytidectomy: a review of 1078 consecutive facelifts. Br J Plast Surg 2001; 54 (06) 481-486
- 28 Jones BM, Grover R. Avoiding hematoma in cervicofacial rhytidectomy: a personal 8-year quest. Reviewing 910 patients. Plast Reconstr Surg 2004; 113 (01) 381-387 , discussion 388–390
- 29 Baker DC, Stefani WA, Chiu ES. Reducing the incidence of hematoma requiring surgical evacuation following male rhytidectomy: a 30-year review of 985 cases. Plast Reconstr Surg 2005; 116 (07) 1973-1985 , discussion 1986–1987
- 30 Gupta V, Winocour J, Shi H, Shack RB, Grotting JC, Higdon KK. Preoperative risk factors and complication rates in facelift: analysis of 11,300 patients. Aesthet Surg J 2016; 36 (01) 1-13
- 31 Ramanadham SR, Mapula S, Costa C, Narasimhan K, Coleman JE, Rohrich RJ. Evolution of hypertension management in face lifting in 1089 patients: optimizing safety and outcomes. Plast Reconstr Surg 2015; 135 (04) 1037-1043
- 32 Niamtu III J. Expanding hematoma in face-lift surgery: literature review, case presentations, and caveats. Dermatol Surg 2005; 31 (9 Pt 1): 1134-1144, discussion 1144
- 33 Warren RJ, Aston SJ, Mendelson BC. Face lift. Plast Reconstr Surg 2011; 128 (06) 747e-764e
- 34 Abboushi N, Yezhelyev M, Symbas J, Nahai F. Facelift complications and the risk of venous thromboembolism: a single center's experience. Aesthet Surg J 2012; 32 (04) 413-420
- 35 Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin-flap survival in the face lift patient. Plast Reconstr Surg 1984; 73 (06) 911-915
- 36 Riefkohl R, Wolfe JA, Cox EB, McCarty Jr KS. Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy. Plast Reconstr Surg 1986; 77 (04) 592-595
- 37 Craig S, Rees TD. The effects of smoking on experimental skin flaps in hamsters. Plast Reconstr Surg 1985; 75 (06) 842-846
- 38 Krueger JK, Rohrich RJ. Clearing the smoke: the scientific rationale for tobacco abstention with plastic surgery. Plast Reconstr Surg 2001; 108 (04) 1063-1073 , discussion 1074–1077
- 39 Lefkowitz T, Hazani R, Chowdhry S, Elston J, Yaremchuk MJ, Wilhelmi BJ. Anatomical landmarks to avoid injury to the great auricular nerve during rhytidectomy. Aesthet Surg J 2013; 33 (01) 19-23
- 40 Klassen AF, Cano SJ, Schwitzer JA, Scott AM, Pusic AL. FACE-Q scales for health-related quality of life, early life impact, satisfaction with outcomes, and decision to have treatment: development and validation. Plast Reconstr Surg 2015; 135 (02) 375-386
- 41 Fleury CM, Schwitzer JA, Hung RW, Baker SB. Adverse event incidences following facial plastic surgery procedures: incorporating FACE-Q data to improve patient preparation. Plast Reconstr Surg 2018; 141 (01) 28e-33e
- 42 Roostaeian J, Rohrich RJ, Stuzin JM. Anatomical considerations to prevent facial nerve injury. Plast Reconstr Surg 2015; 135 (05) 1318-1327
- 43 Baker TJ, Gordon HL, Mosienko P. Rhytidectomy: a statistical analysis. Plast Reconstr Surg 1977; 59 (01) 24-30
- 44 Passot R. La chirurgie esthetique des rides du visage. Presse Med 1919; 27: 258-262
- 45 Hollander E. Plastische (Kosmetische) Operation: Kritishce Darstellung ihres gegenwartigen Stands. In: Klemperer G, Klemperer F. eds. Neue Deutsche Klinik: Handwörterbuch der praktischen Medizin mit besonderer Berücksichtigung der inneren Medizin, der Kinderheilkunde und ihrer Grenzgebiete. Vol. 9. Berlin: Urban & Schwarzenberg; 1932: 1-17
- 46 Lexer E. Die gesamte Wiederherstellungschirurgie. Vol. 2. Leipzig: JA Barth; 1931
- 47 Joseph J. Hangewangenplastic (Melomioplastik). Dtsch Med Wochenschr 1921; 47: 287-288
- 48 Bames HO. Truth and fallacies of face peeling and face lifting. Med J Record 1927; 726: 86-87
- 49 Bettman AG. Plastic and cosmetic surgery of the face. Northwest Med 1920; 91: 205-209
- 50 Hoefflin SM. The extended supraplatysmal plane (ESP) face lift. Plast Reconstr Surg 1998; 101 (02) 494-503
- 51 Skoog T. New Methods and Refinements. Plastic Surgery. 1st ed. Stockholm, Sweden: Almgrist and wicksell International; 1974: 300-330
- 52 Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 1976; 58 (01) 80-88
- 53 Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg 1990; 86 (01) 53-61 , discussion 62–63
- 54 Psillakis JM, Rumley TO, Camargos A. Subperiosteal approach as an improved concept for correction of the aging face. Plast Reconstr Surg 1988; 82 (03) 383-394
- 55 Owsley Jr JQ. Platysma-fascial rhytidectomy: a preliminary report. Plast Reconstr Surg 1977; 60 (06) 843-850
- 56 Owsley Jr JQ. SMAS-platysma face lift. Plast Reconstr Surg 1983; 71 (04) 573-576
- 57 Aston SJ. Platysma-SMAS cervicofacial rhytidoplasty. Clin Plast Surg 1983; 10 (03) 507-520
- 58 Stuzin JM, Baker TJ, Gordon HL, Baker TM. Extended SMAS dissection as an approach to midface rejuvenation. Clin Plast Surg 1995; 22 (02) 295-311
- 59 Baker SR. Triplane rhytidectomy. Combining the best of all worlds. Arch Otolaryngol Head Neck Surg 1997; 123 (11) 1167-1172
- 60 Connell BF. Eyebrow, face, and neck lifts for males. Clin Plast Surg 1978; 5 (01) 15-28
- 61 Connell BF, Marten TJ. The trifurcated SMAS flap: three-part segmentation of the conventional flap for improved results in the midface, cheek, and neck. Aesthetic Plast Surg 1995; 19 (05) 415-420
- 62 Tonnard P, Verpaele A, Monstrey S. et al. Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 2002; 109 (06) 2074-2086
- 63 Virenque M. Traitement chirurgical des Rides de la Face et du Cou. In: La Pratique Chirurgicale Illustrée. Paris: Doin; 1927: 1-15
- 64 Cardoso de Castro C. The changing role of platysma in face lifting. Plast Reconstr Surg 2000; 105 (02) 764-775 , discussion 776–777
- 65 Millard Jr DR, Mullin WR, Ketch LL. Surgical correction of the fat neck. Ann Plast Surg 1983; 10 (05) 371-385
- 66 Wan D, Small KH, Barton FE. Face lift. Plast Reconstr Surg 2015; 136 (05) 676e-689e
- 67 Wang R, Yang J, Guo K. et al. Periauricular purse-string reinforced with SMAS plication and malaria fat pad elevation for mid-and lower facial rejuvenation: FACE-Q report. Ann Plast Surg 2018; 81 (Suppl. 01) S59-S65
- 68 Ziarah HA, Atkinson ME. The surgical anatomy of the cervical distribution of the facial nerve. Br J Oral Surg 1981; 19 (03) 171-179