title: Secondary Neck Lift and the Importance of Midline Platysmaplasty: Review of 101 Cases.
abstract: BACKGROUND
  The authors believe that open access to the submental region, platysmaplasty, and wide skin undermining provide the most long-lasting results in neck rejuvenation, and sought to evaluate this hypothesis by reviewing their neck-lift patients.
  
  
  METHODS
  The authors performed a retrospective chart review of their experience with neck-lift procedures and patients who underwent a secondary procedure. Patient age, sex, initial technique, visible neck deformities, and reasons for revision were assessed. Photographs were used to assess the features of persistent or recurrent neck-lift deformity and techniques to correct them.
  
  
  RESULTS
  Of 1089 neck lifts reviewed, 101 patients underwent secondary or revision procedures (approximately 10 percent of total). The average patient age was 57.4 years, 95 percent were women, and secondary procedures were performed 10.3 years after the first procedure. Seventy percent of the revisions were of the authors' own primary neck lifts, and all of these after 10 years. The most common aesthetic deformities--recurrent platysmal bands (87 percent), persistent/recurrent jowling (48 percent), fat malposition/irregularities (10 percent), and vertical band deformity (8 percent)--were most often corrected with open platysmaplasty and medial or lateral plication and skin redraping. All patients had their submental region opened in the secondary procedure. All secondary operations were performed at least 10 years after primary surgery.
  
  
  CONCLUSIONS
  The authors believe their technique of open submental neck access and platysmal approximation in patients with medial bands provides long-lasting results. The authors use precise preoperative evaluation, recontouring of neck fat irregularities, opening of the submental region with platysmaplasty, drains, and strict hemostasis.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Sherman and Dallas, Texas; Boston, Mass.; and San Diego, Calif.|From the Sherman Surgery Center; the Division of Plastic and Reconstructive Surgery, Boston University School of Medicine; the Department of Plastic Surgery, Naval Medical Center San Diego, United States Navy; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Kailash
authors.initials: K
authors.lastname: Narasimhan
authors.affiliation: Sherman and Dallas, Texas; Boston, Mass.; and San Diego, Calif.|From the Sherman Surgery Center; the Division of Plastic and Reconstructive Surgery, Boston University School of Medicine; the Department of Plastic Surgery, Naval Medical Center San Diego, United States Navy; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Smita
authors.initials: S
authors.lastname: Ramanadham
authors.affiliation: Sherman and Dallas, Texas; Boston, Mass.; and San Diego, Calif.|From the Sherman Surgery Center; the Division of Plastic and Reconstructive Surgery, Boston University School of Medicine; the Department of Plastic Surgery, Naval Medical Center San Diego, United States Navy; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Eamon
authors.initials: E
authors.lastname: O'Reilly
authors.affiliation: Sherman and Dallas, Texas; Boston, Mass.; and San Diego, Calif.|From the Sherman Surgery Center; the Division of Plastic and Reconstructive Surgery, Boston University School of Medicine; the Department of Plastic Surgery, Naval Medical Center San Diego, United States Navy; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D012060:Rejuvenation; D012086:Reoperation; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*