摘要

Objectives: 1: Diagnose platysmal laxity 2: Identify submandibular gland hypertrophy versus ptosis 3: Formulate a tailored approach to all of the segments of aging in the neck. 4: Manage neck aging using surgical techniques such as subcutaneous liposuction, subplatysmal fat reduction, submandibular gland reduction, platysmaplasty, platysma hammock, digastric resection, and extended deep plane facelift. Introduction: The evolution of neck aging occurs through many different contributing factors. Maximizing treatment of the aging neck requires proper diagnosis of the relative factors like skin laxity, platysmal muscle banding/descent, fat hypertrophy, and submandibular gland ptosis. Meticulous surgical techniques tailored to each individual neck can give a dramatic and natural rejuvenation. The speaker is a double-board certified Facial Plastic Surgeon in the United States who specializes in Extended Deep Plane Facelift techniques, performing over 200 of these procedures annually. Materials / method: The treatment of the neck begins prior to the surgical procedure with proper diagnosis. The quality of the skin and presence of sun damage on the elasticity is determined. Abundance of subcutaneous fat might indicate limited neck liposuction, while a slender neck would preclude liposuction. The deep structures of the neck are meticulously sculpted and the anterior digastric muscles are completely divided and excised. Medial platysmal plication and lateral platysma hammock via extended deep plane facelift are performed. Results: Photographic results and intraoperative video demonstration are shared of the techniques used. Indications and contraindications for each of the individual maneuvers are shared to assist with surgical planning. Post-operative care and expectations are reviewed in the presentation. Conclusion: The gold standard to maximum rejuvenation of the aging neck is a surgical approach using the combination of Deep Neck Lift with Extended Deep Plane Facelift. This dramatically addresses the presence of skin laxity, platysmal banding, neck adipose, submandibular gland ptosis, and deep muscle hypertrophy. The result is a beautiful and youthful rejuvenation of the jawline and neckline.