Neck Contouring Without Rhytidectomy in the Presence of Excess Skin

Advancements in Face and Neck Contouring: Integrating Radiofrequency-Assisted Liposuction with FaceTite and Buccal Fat Pad Excision for Facial Slimming

BACKGROUND

The integration of neck liposuction with FaceTite Manipulus Radiofrequency (RF) technology and buccal fat pad excision for enhanced neck rejuvenation promise heightened precision and efficacy in sculpting the neck and jawline. Neck liposuction, coupled with RF technology, provides controlled thermal energy for adipose tissue treatment and collagen remodeling, while buccal fat pad excision offers refined contouring of the lower face and neck. This integrated approach aims to optimize patient outcomes and advance the field of esthetic plastic surgery.

METHODS

A prospective study was conducted from 2016 to 2023 on 80 consecutive patients who presented to the author's private clinic and required neck remodeling surgery for esthetic purposes. Patients were monitored and clinic appointments were scheduled at intervals of 0, 1, 3, 6 and 12 months post-treatment for evaluation. A tape measure recorded submental length at 1 and 6 months, and a satisfaction survey was administered one week before surgery and after six months. Physicians assessed improvement using a five-point scale for patient satisfaction and a four-point scale for overall improvement.

RESULTS

All patients underwent successful RFAL treatment, consistently achieving satisfaction with the outcomes. The average reduction in submental length measured 23 mm during the 6-month follow-up period. Additionally, the removal of buccal fat pads played a pivotal role in facial slimming and enhancing the esthetics of the upper cheek region.

CONCLUSIONS

The integration of neck liposuction with FaceTite RF technology and buccal fat pad excision offers a promising approach for enhanced neck rejuvenation and facial contouring. This combined method demonstrates heightened precision and efficacy in sculpting the neck and jawline, aiming to optimize patient outcomes and advance the field of esthetic plastic surgery.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Isolated Medial Platysmaplasty and Harmonization of the Lower Third of Face with Local Fat Autograft: A Case Report

One of the most common complaints of patients seeking plastic surgery is the presence of age-related changes in the lower third of the face. These often include vertical platysmal bands, a double chin, Venus rings, the absence of the cervico-mental angle, hypertonicity of the muscles in the mental area, and insufficient projection of the chin. The development and implementation of less-traumatic methods of correction of the lower third of the face and harmonization of the projection of the cervico-mental region remain relevant. This article discusses a comprehensive and individualized approach with minimally invasive techniques for correcting age-related changes in the lower third of the face and harmonizing the definition of the jawline. Isolated platysmaplasty with autologous local fat grafting to the chin is effective, safe, minimally invasive, and has a short rehabilitation period, with stable long-term aesthetic outcomes.

Rejuvenation in Men Facial Aging: A Combined Approach

Facelift surgery, also known as rhytidectomy, is a popular cosmetic procedure aimed at reversing the signs of facial aging. While facelift surgery is more commonly performed in women, an increasing number of men are seeking this procedure to maintain a youthful appearance. The long recovery period conflicts the overall primary outcome anticipated by men undergoing rhytidectomy, i.e., appear younger, youthful, and ready to reaffirm their value in the working environment. Anterior direct neck lift, blepharoplasty (upper and lower eyelid blepharoplasty), and lipofilling are three techniques that have been shown to be effective in improving facial rejuvenation outcomes in elderly male patients. However, there is little to no evidence of the safety and efficacy of these techniques when used in combination. By combining these techniques, we hypothesized that we could achieve outcomes comparable to traditional facelift surgery, but with a lower risk of complications and a shorter recovery time. We conducted a retrospective case series study of 18 male patients who underwent facial rejuvenation surgery using the combination of anterior direct neck lift, blepharoplasty (upper and lower eyelid blepharoplasty), and lipofilling at our institution between 2018 and 2021. All 18 patients completed the study, with an average follow-up of 12 months. No major complications were observed, and all patients reported a high level of satisfaction with their outcomes.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Necklift: the optimal local technique for each neck]

Eine Vielzahl Patienten stört nur der Hals, sei es ein leichtes Doppelkinn, ein Fetthals, die auffälligen medialen Platysma-Stränge oder ein richtiger „turkey gobbler“. Für jede dieser Indikationen gibt es eine geeignete Operationsmethode, die Alter und Vorstellung der Patienten, aber auch die Beschaffenheit der Haut, deren Fettgehalt, und die Ausprägung der Falten im ganzen Gesicht und am Hals in Betracht zieht. Hier werden 8 verschiedene moderne Techniken vorgestellt, die einzeln, aber auch in Kombination durchgeführt, für jeden Patienten individuell ausgewählt werden können. 1. Ein „angedeutetes Doppelkinn“ wird abgesaugt 2. Ein „ausgeprägtes Doppelkinn“ wird horizontal exzidiert 3. Ein „reiner Fetthals“ wird abgesaugt und die Haut exzidiert 4. „Lockere Halshaut“ wird vertikal exzidiert oder als Facelift gestrafft 5. Ein ausgeprägter “Truthahnhals“ wird vertikal exzidiert oder als vertikales Facelift gestrafft

Anterior Approach to the Neck: Long-Term Follow-Up

BACKGROUND

The anterior or submental necklift has been well described. Long-term results have been demonstrated in patients with minimal, mild, and moderate skin excess. It relies on the skin's unique ability to contract once separated from its attachments and further enhances the surgical result with treatment of the intermediate layer- subplatysmal fat, anterior digastric, submandibular gland, and platysma. Treatment of this layer differentiates this operation from liposuction and offers benefits beyond liposuction alone.

OBJECTIVES

The authors sought to assess the long-term success of the anterior necklift for neck rejuvenation and determine its utility in patients with severe cervicomental angles.

METHODS

This was a single-surgeon, retrospective review of patients who underwent an isolated anterior necklift with no additional procedures between 1998 and 2017. Pre- and postprocedure photographs were scrambled and examined by independent evaluators grading the change in cervicomental angle based on the Knize scale. The reduction in apparent age was calculated utilizing the validated apparent age assessment scale.

RESULTS

Twenty-seven patients were evaluated (42% mild and 58% moderate to severe necks preoperatively). The average follow-up was 24.7 months. There was an average 3.6-year age reduction and 1.0-grade improvement in all patients. In moderate to severe necks, there was a 3.9-year age reduction and 1.4-grade improvement in the cervicomental angle following surgery.

CONCLUSIONS

This study demonstrates the effectiveness of the operation in improving the cervicomental angle and reducing the overall apparent age of patients, even more so in severe cases. The operation is an option for patients who desire neck improvement but are unwilling to undergo a facelift.

LEVEL OF EVIDENCE: 4

Partial Removal of the Submaxillary Gland for Aesthetic Indications: A Systematic Review and Critical Analysis of the Evidence

BACKGROUND

Neck aesthetics is an essential feature for a youthful attractive appearance. Deep neck surgery involving partial resection of the submandibular gland (SMG) has been a controversial issue in aesthetic surgery given its challenging technique and potential risks. The aim of this review is to evaluate the safety and efficacy of partial SMG resection in patients undergoing aesthetic neck surgery.

METHODS

We undertook a systematic review of the literature and analysis of studies reporting surgical outcomes and complications of partial SMG resection from Medline, Cochrane and Google Scholar databases from 1950 to March 30, 2019. Two independent reviewers conducted titles and abstracts screening and data extraction. Data were analyzed using mixed methods appraisal tool and a clinical impact score.

RESULTS

Six studies including 602 patients who underwent 1200 partial SMG resections were included. All studies reported aesthetic improvement according to Ellenbogen aesthetic neck ideals. Hematoma related to partial SMG resection was encountered in one case (0.08%), hematoma related to cervicofacial skin flap was encountered in 26 cases (1.4%), sialoceles happened in 16 cases (1.3%), transient marginal mandibular nerve weakness occurred in 86 cases (4.7%). No mortalities, permanent motor nerve damage or dry mouth were reported. The clinical impact score was positive for five out of the six reports.

CONCLUSION

Partial SMG resection in patients undergoing aesthetic neck surgery may represent an effective procedure to enhance neck aesthetics and is associated with minor, self-limiting complications. Future controlled studies with prospective evaluation of aesthetic outcome and patient-reported outcome measures are needed.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.