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P o i n t fo r N e c k Re j u v e n a t i o n
Procedures
Athanasios Athanasiou, MD, PhDa,*,
Georgios Rempelos, MDb
KEYWORDS
Neck rejuvenation Procedures Neck lift Platysma muscle
KEY POINTS
Lorres fascia as anchor point provides strong support to the young hanging neck without the need
for further subplatysmal dissection.
An additional subplatysmal dissection and submental approach with liposuction and digastric
manipulation addresses problems of heavier problematic necks.
Facial contour is restored in a natural, long-lasting result.
The authors present a brief video clip of their skin fixation in neck rejuvenation accompanies this
article at http://www.interventional.theclinics.com/
Editor Commentary: Athanasias spent a six month aesthetic fellowship with me and frequently visited
Bruce Connell as well. He shares his answers to my questions in a logical manner utilizing the strength
of Lores fascia and the mastoid fascia to anchor the SMAS/platysma flap. These fixed structures limit anterior and inferior flap migration after anchoring. He describes his approach to the various layers of submandibular fat as well as the indication for partial resection of the anterior belly of the digastrics muscles. His
European patient population includes many smokers and his admonition to avoiding aggressive flap
dissection is important to remember.
The surgical necessity to individualize each patients needs to one specific technique enabling
the surgeon to offer a satisfactory result in all varieties of an aging neck is meaningless.115 From
our experience, there is no one-for-all technique
to address every anatomic area found in existing
or potential problems on the constantly shrinking
neck cylinder. Skin flaccidity, supraplatysmal or
subplatysmal excess fat, mandibular border definition, visible active or static platysma muscle
bands, and submaxillary gland protrusion form
a
Private Practice, Laodikis 33-35 Glyfada, Greece;
tower, 11523 Ampelokipi, Athens, Greece
* Corresponding author.
E-mail address: tanasisa@yahoo.gr
plasticsurgery.theclinics.com
TECHNIQUE
Managing Aging Necks
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Fig. 3. Extended
rejuvenation.
SMAS
mobilization
for
neck
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small bites from the mastoid fascia up to the proximal third of the mandible in order to avoid any
damage to the marginal mandibular branch, using
4.0 nylon sutures. This surgical manipulation
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SUPPLEMENTARY DATA
Supplementary data related to this article can be
found online at http://dx.doi.org/10.1016/j.cps.
2013.09.008.
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