title: Neck lift my way: an update.
abstract: BACKGROUND
  The author updates prior descriptions of an approach to the surgical neck lift that aims for a maximum degree of control over the size, shape, and position of every anatomical feature of the neck that is negatively affecting its appearance.
  
  
  METHODS
  A 38-year clinical experience guided the development of the operative tactics that define the strategy. Data collected from a records review of 522 consecutive neck lifts performed during the 10-year period 2004 through 2013 further inform the report. The approach has eight features: (1) nearly routine use of open submental access to all tissue layers of the central neck, including a regimen that curbed the problems that may attend an extensive tissue dissection; (2) management of lax neck skin by lateral excision using a specific postauricular incision, or by using the nonexcisional method of redistribution; (3) open lipectomy for precise removal of excess subcutaneous neck and jawline fat; (4) individualized modifications to subplatysmal fat, perihyoid fascia, and anterior digastric muscles; (5) treatment of large, ptotic, or malpositioned submandibular salivary glands by partial excision using a transcutaneous traction suture; (6) the current version of the corset platysmaplasty, which is used to treat static paramedian platysma muscle bands, and to avoid contour imperfections following subplatysmal maneuvers; (7) an approach that facilitates an isolated neck lift; and (8) durable results.
  
  
  RESULTS
  Case examples demonstrate outcomes.
  
  
  CONCLUSIONS
  Although the updated approach remains relatively complex and invasive, the author believes that the ends justify the means.
authors.affiliation: Cambridge and Boston, Mass. From private practice, and the Department of Surgery, Harvard Medical School.
authors.forename: Joel J
authors.initials: JJ
authors.lastname: Feldman
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D009334:Neck Muscles / Q000601:surgery*; D063868:Patient Outcome Assessment; D015361:Rhytidoplasty / Q000379:methods*