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Objectives: - Develop a structured approach to assessing the neck based on anatomical layers
- Select the appropriate surgical (and non-surgical) treatments based on the anatomical layer(s) affected and severity
- Understand the efficacy and limitations of each treatment option

Introduction: There are a range of surgical procedures for the neck and it is important to understand how to choose the most appropriate procedure to achieve the best outcomes. Each non-surgical and surgical treatment option for the neck has their own efficacy and risk profiles depending on indication, technique, expertise. Patient selection & managing expectations are key - how to assess, predict results & choose the best treatment.

Materials / method: This is a systematic guide to examination and treatment of the neck based on:
- features of the aesthetic neck
- anatomical layers
- severity

Results: How the various surgical procedures can be selected for the appropriate patient (including ultrasound-assisted liposuction, face/neck lift, platysmaplasty and direct neck lift) will be discussed, along with their efficacies and limitations.

Conclusion: It is important to develop treatment algorithms based on expertise/equipment. Surgery requires systematic assessment of patients, considering different anatomical layers and different treatment options for varying severity. Procedures should be tailored based on patients concerns, priorities & expectations.

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Objectives: personal expiriens of performing modern full-face lift
&neck lift to achive a natural result ithout long preauricular scars

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Objectives: Understanding the anatomy of deep neck structures can be the primary limiting factor for some surgeons to not adequately address the submentum. Effective surgical manipulation of the deep neck structures can markedly improve the contour of the submentum without skin removal from a necklift approach. Additionally, by combining energy based devices, one can optimize deep neck sculpting outcomes and maximize the contour in a less invasive manner.

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Objectives: Severe neck laxity represents a challenge for the aesthetic medicine. Aesthetic doctors usually don't master the surgical techniques required to effectively improve those critical patients; therefore they either 'quit' them, leaving their patients unhappy, or they try treating them, often with disappointing results.
Nefertiti btx helps moderate platysmal laxity. HA Jawline definition camouflages a bit of skin excess. Technologies, threads can help when the laxity is moderate, but cannot achieve the surgery's effectiveness. A step by step technique is shown with it's results and indications

Introduction: Remarkable improvements have been achieved in the field of aesthetic medicine;yet some patients' results are not satisfactory if using only cosmetic procedures. People with severe neck area laxity, are a challenge for aesthetic medicine.Trying to reach a decent result in those patients,physicians may overtreat or overfill,causing innatural and undesirable results.Purpose of this presentation is to show an easy and safe face and neck lift technique and it's results. To show how, in selected patients, face/neck surgery should be a better choice in order to achieve natural and lasting results

Materials / method: In our 11 years’ experience, we have treated about 2.000 patients aged from 38 to 75 YO, with our face-neck lift technique. Some of them were 'virgin', others had unsatisfactory results with cosmetic procedures, and seeking a surgical approach. We had a thorough follow up. Thanks to this experience, we can outline the pros and cons of each technique, the efficacy of them over time and - most important - the limits of result available from aesthetic medicine, technologies and surgery.

Results: Assessment is crucial when treating the neck area.Skin laxity,platysma involvement, jaw bone resorption, sub-mental fat:all of these should be accounted to understand whether a cosmetic procedure may give a proper result, or if surgery is advisable. Tighter skin,platysma band may benefit of injections. But severe sagging, relaxed skin, subcutaneous fat require surgery to have an effective and long lasting neck reshaping. Patients need a tailor-made approach:so the doctor should master all the different solutions possible, in order to give them the best result and avoiding unnatural appearance

Conclusion: Aesthetic medicine is doing huge leaps forward these years, yet there still are some limits in its efficacy, especially in the neck regions. Patients, struck by pounding advertising, may believe that an injection,a thread or a technology may solve all their problems. However, such believes can't be accepted in professionals. Doctors have to know exactly the limits and boundaries of each technique. Either Medicine or Surgery, it's supposed to be Aesthetic. Pushing their limits, creates dysmorphies:Bad advertising for all of us... Knowing their limits, and mastering both of them, creates beauty

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Objectives: Are plastysmal transection and salivary gland removal necessary?

Introduction: Determining which facelift procedures yield the most long-term rejuvenating effects and stability over time is an important question in cosmetic surgery: does radical and invasive surgery produce the most long-lasting results?

Materials / method: This is even more important with regards to weight loss sequelae as most of the time the tissues have lost their elasticity with subsequent recurrences. The experience of our team suggests that using a combination of various techniques (open lipectomy, myotomies and myomectomies, suspensions, regenerative medicine techniques, salivary glands and digastric muscles management,) appears to be essential to achieve satisfactory, lasting results.

Results: The learning curve is a little longer, but it increases the efficiency and durability of the procedure while simplifying the follow-up. The necessity of platysmal transection and salivary gland removal depends on specific medical needs. Platysmal transection and salivary gland removal are often employed in cosmetic surgery to improve neck aesthetics.

Conclusion: Both procedures should be considered after thorough consultation to evaluate the benefits and risks based on the patient’s health and treatment objectives.

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Objectives: To compare an endoscopic composite flap brow, face and necklift technique to an open composite flap technique in a similar cohort of patients treated by the same surgeon

Introduction: Even as modern composite flap and deep-plane facelift techniques evolve to produce increasingly natural-appearing
results, the preauricular incision remains a major stigma for many patients. This led the author to develop, for cases
with mild to moderate skin laxity, an endoscopic-assisted, en-bloc composite flap face and necklift without a
preauricular scar. This paper compares the effectiveness of the author’s “scarless” endoscopic technique with
“open” techniques in patients with similar indications and average age. The author describes his technique in detail.

Materials / method: Forty-four consecutive patients underwent endoscopic composite flap face and necklift by the author. Forty-four
similar patients undergoing “open” composite flap lifting during the period before the author began performing the
endoscopic facelift technique. The vertical dimension of skin elevation in both midface and pre-auricular areas was measured in pixels, then normalized as a percentage of total facial height, using size-matched 19 month postoperative (average) high-resolution antero-posterior and lateral photographs. The two groups were compared.

Results: Average vertical skin elevation in endoscopic composite flap lift patients was 1.984 percent (midface) and 5.293
percent (pre-auricular), compared with 1.605 percent and 5.852 percent in the open composite flap group. A paired T-test revealed no statistically significant difference between the two groups (p-values, 0.314 for midface and 0.448
for preauricular).

Conclusion: In selected patients with deep-tissue laxity but minimal to moderate skin excess, endoscopic en-bloc composite-flap
lifting of the SMAS-platysma is a safe and effective technique to achieve a result equivalent to open composite
techniques while avoiding a preauricular scar.

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Objectives: Sharing my experience in facelift; from SMAS plication to deep plane and showing the impact on long term results.

Introduction: Deep plane facelift was described long time ago. However in the last few years was widely modified and popularised.
Shifting to different technique has pros and cons that will be discussed in this talk.

Materials / method: I’ll go through my facelift journey starting by subcutaneous plane with deep tissue plication earlier in my practice till a turning point 2 years ago where I shifted extensively to deep plane facelift and deep neck sculpting.

Results: Although results of both group of patients were comparable on the short term. Deep plane technique showed better longevity of the results with massive incomparable correction of midface.

Conclusion: Good and long term results after deep plane lift compared to other SMAS techniques can justify the routine use of it in primary facelifts. However in secondary cases, other techniques might be safer.

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