Neck Lift My Way: An Update

作者：Feldman Joel J^*

来源：Plastic and Reconstructive Surgery, 2014, 134(6): 1173-1183.

DOI：10.1097/PRS.0000000000000712

Background: The author updates prior descriptions of an approach to the surgical neck lift that aims for a maximum degree of control over the size, shape, and position of every anatomical feature of the neck that is negatively affecting its appearance.
Methods: A 38-year clinical experience guided the development of the operative tactics that define the strategy. Data collected from a records review of 522 consecutive neck lifts performed during the 10-year period 2004 through 2013 further inform the report. The approach has eight features: (1) nearly routine use of open submental access to all tissue layers of the central neck, including a regimen that curbed the problems that may attend an extensive tissue dissection; (2) management of lax neck skin by lateral excision using a specific postauricular incision, or by using the nonexcisional method of redistribution; (3) open lipectomy for precise removal of excess subcutaneous neck and jawline fat; (4) individualized modifications to subplatysmal fat, perihyoid fascia, and anterior digastric muscles; (5) treatment of large, ptotic, or malpositioned submandibular salivary glands by partial excision using a transcutaneous traction suture; (6) the current version of the corset platysmaplasty, which is used to treat static paramedian platysma muscle bands, and to avoid contour imperfections following subplatysmal maneuvers; (7) an approach that facilitates an isolated neck lift; and (8) durable results.
Results: Case examples demonstrate outcomes.
Conclusion: Although the updated approach remains relatively complex and invasive, the author believes that the ends justify the means.

• 出版日期2014-12