title: Wide-undermining neck liposuction: tips and tricks for good results.
abstract: BACKGROUND
  Neck rejuvenation is one of the most sought after procedures in the restoration of the facial contour. Numerous techniques to improve the aesthetic outcome and reduce downtime have been described. In our experience, wide undermining and local anesthesia are key to obtaining good results in selected patients who want a quick recovery. This article presents our experience with liposuction of the neck and proposes some tips and tricks to master wide-undermining neck liposuction.
  
  
  METHODS
  From January 2005 to September 2012, a total of 118 patients (34 males, 84 females) underwent neck liposuction. Patient selection was based mainly on age and neck-aging features. The procedure was performed with the patients under local anesthesia. A wide rhomboid-shaped skin undermining of the submandibular and neck area was performed and a very thin fat layer was preserved. Dressing was applied for 3 days.
  
  
  RESULTS
  Improvement of the neck's contour was observed in all patients. Redefinition of the cervicomandibular angle and skin redraping of the cervical area occurred in all cases. No further touch-ups were needed. Edema and ecchymosis resolved in a few days. No major complications were observed.
  
  
  CONCLUSIONS
  Our results show that wide-undermining neck liposuction performed under local anesthesia is an effective and safe procedure. Patient selection based on age and anatomical features was fundamental to obtain impressive improvement of neck contour.
  
  
  METHODS
  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 .
authors.affiliation: Plastic Surgery Department and Burn Unit, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162, Milan, Italy, innocentialessandro@alice.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Innocenti
authors.forename: Chiara
authors.initials: C
authors.lastname: Andretto Amodeo
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciancio
mesh_terms: D000328:Adult; D001963:Bromelains / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D064827:Myocutaneous Flap; D009333:Neck / Q000601:surgery*; D009334:Neck Muscles / Q000601:surgery; D012060:Rejuvenation
chemical_list: D001963:Bromelains