Abstract

Objectives: This retrospective study describes the simple reproducible complication free approach to restoring the neck after massive weight loss. With a stable weight of the patient it allows for accurate preoperative planning and a straightforward procedure. It results in a visible but pleasing scar as a trade off for improved neck contour of the MWL patients. With consideration of the type of neck deformity and following the suggested treatment algorithm according to our grading scale this procedure is a great amendment to weight loss surgery. Introduction: The number of patients with history of obesity and massive weigh loss (MWL) is continuously rising. Patients are left with damaged ptotoc skin, contour deformities, causing intertriginous disorders. Once major areas of excess skin have been removed the patient is often left with stigmatizing skin redundancies at the neck an apparent area with little options to cover up. Currently no classification for neck deformities after MWL exists and the operation planning is individual. We therefore propose a classification and treatment algorithm for MWL triggered deformities of the neck. Materials / method: The authors introduce options of isolated neck lift procedures in MWL patients. According to the grade of deformity a treatment algorithm is proposed. A retrospective study was carried out on 17 patients. All patients were operated on, by the senior surgeon in a 6 year period from Jan 2012 to Dec 2017. In 14 cases a direct submental incision was applied for skin excision while in 3 cases neck tightening was achieved by a star-excision or zigzag zorro-scar in the midline. Resulting scarring and complications are compared to a patient group receiving neck procedures for aesthetic reasons. Results: In the study group 17 patients after massive weight loss (BMI drop averages at 19.6) underwent a neck lift. All patients received concomitant surgery without raising complication risks. No complications were noted in the treatment group. Scar quality was rated acceptable to good in all patients. Conclusion: The direct excision neck lift showes to be a reliable technique with rare complication rates throughout the group of MWL patients and aesthetic patients. Once a stable weight has been achieved the submental ptotic tissue is a mere skin redundancy in MWL patients, liposuction has not been necessary. The submental neck lift can safely be performed together with other postbariatric procedures and improves appearance.