Neck deformities, either of congenital or more commonly aging origin, are frequent sources of invasive and non-invasive procedures for improvement. At the opposite ends of the spectrum for neck contouring are injections (Kybella) and skin tightening devices to a full lower neck lift. (facelift) While each of these have their roles depending upon the magnitude of the neck contour deformity and the patient’s age, there are some patients that lie somewhere between the least invasive and the most invasive aesthetic neck reshaping treatment options.
When it comes to an isolated ‘necklift’, this concept has variable interpretations. But what it fundamentally means is that the surgical neck reshaping is done without the use of ear incisions. (when ear incisions are used this is known as a lower facelift or full neck lift) And it also indicates that it is more than just liposuction alone. Some more direct form of fat removal and platysmal muscle modifications are done. This is historically known as a submentoplasty, often performed as a secondary touchup after a primary full facelift for rebound central neck relaxation or done as a primary procedure. (which works especially well when done in conjunction with chin augmentation)
In the 2020 Global Open Issue of Plastic and Reconstructive Surgery journal an article on this topic was published entitled ‘The Single Incision Minimally Invasive (SIMI) Neck Lift.’ In this clinical paper the author reviews a series of twenty (20) patients that received an isolated neck procedure consisting of a cervicomental incision through which is performed full neck liposuction, neck skin flap elevation, subplatsymal defatting and midline platysmal muscle plication. Candidates for this procedure were based on the Pythagorean theorem in which the loose neck skin must fall within the hypotenuse of the triangle.
Of the twenty patients only one complication was seen (hematoma) which was surgically resolved.
The SIMI necklift differs slightly from the traditional submentoplasty in the location of the incision. With a more central mid-neck access the cervicomental region can be more directly treated. A debate can be had about whether this is superior to the more superior submental incision location. But what is really helpful int the article is the preoperative method used to determine who would be a good candidate for the isolated neck lift procedure using a some classic geometry. While a very experienced surgeon may be able to eyeball who is a good candidate for it applying a simple mathematical analysis is very helpful for surgeon and patient alike. The one caveat that I may add is that the analysis and candidacy of a patient may change if a chin augmentation of any magnitude is to be simultaneously performed.
The cervicomental incision necklift adds to the surgeon’s repertoire of neck reshaping options. While its use may be limited to a very specific type of neck shape, it is another approach to offer the patient whose neck is beyond what non-surgical methods can improve but is not yet ready or needs a formal full lower necklift.
Dr. Barry Eppley