Facial Plast Surg
DOI: 10.1055/a-2708-5392
Original Article

Direct Neck Lift in Men

Authors

  • Parker A. Velargo

    1   New Orleans Center for Aesthetics and Plastic Surgery, New Orleans, Louisiana, United States
  • John C. Holtrop

    2   Tulane University School of Medicine, Department of Plastic Surgery, New Orleans, Louisiana, United States
  • Bill D. Aukerman

    2   Tulane University School of Medicine, Department of Plastic Surgery, New Orleans, Louisiana, United States
  • Vidhur R. Sohini

    2   Tulane University School of Medicine, Department of Plastic Surgery, New Orleans, Louisiana, United States
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Abstract

Aims and Backgrounds

Direct submentoplasty remains a valuable alternative to rhytidectomy in male patients, addressing cervical laxity and fullness while avoiding feminization, periauricular scars, and prolonged recovery associated with traditional rhytidectomy.

Historical Aspects

Since the early 20th century, submental skin excision has undergone refinement, progressing from horizontal ellipses to advanced configurations such as the Grecian urn pattern. These modifications aim to optimize scar camouflage while correcting horizontal and vertical redundancy.

Anatomy

Key anatomic contributors to cervical aging include skin and platysmal laxity, supra- and subplatysmal fat, anterior belly of the digastric hypertrophy, ptotic submandibular glands, and a low-lying hyoid. Comprehensive preoperative analysis is required to address these factors.

Patient Selection

For patients presenting with submental fullness accompanied by good skin elasticity and minimal skin laxity, an isolated deep structural neck lift without skin excision may be sufficient. Optimal candidates for direct cervicoplasty (skin excision) demonstrate submental laxity limited to above the thyroid cartilage, minimal jowling, and acceptance of an anterior cervical scar.

Techniques

The isolated deep structural neck lift addresses the platysma and its underlying structures without the need for skin excision. A direct cervicoplasty with skin excision affords wide exposure for addressing the skin, platysma, and the subplatysmal anatomy. Skin excision patterns are varied and tailored to the patient's needs.

Postoperative Care

Scar modulation strategies, drain management, lymphatic assistance with positioning/massage, and salivary flow management are key to a hastened recovery.

Conclusions and Clinical Relevance

Direct submentoplasty remains an essential tool in the aging male patient, offering reproducible results in appropriately selected patients who are willing to accept its limitations.



Publikationsverlauf

Eingereicht: 21. September 2025

Angenommen: 23. September 2025

Accepted Manuscript online:
24. September 2025

Artikel online veröffentlicht:
07. Oktober 2025

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