Surgical Approaches to Cervicofacial Rejuvenation:
A Review of Contemporary Methods

Based on the Review Article: Advanced Surgical Approaches for the Rejuvenation of the Submental and Cervicofacial Regions: A Literature Review for a Personalized Approach

Rejuvenation of the neck and lower face is becoming increasingly popular among patients seeking long-lasting aesthetic improvements. The primary reasons for pursuing aesthetic procedures include skin laxity, the presence of platysmal bands, accumulation of submental adipose tissue, and mandibular sagging. This article analyzes the latest surgical approaches aimed at achieving natural and durable results.

1. Anatomy and Aesthetic Criteria

The ideal cervicofacial region is characterized by:

  • A well-defined cervicomental angle (90–110°)
  • Absence of platysmal bands
  • Firm skin without excess tissue
  • A smooth transition between the lower jawline and the neck

Age-related changes often involve a combination of skin laxity, submandibular gland hypertrophy, alterations in platysmal structure, and redistribution of adipose tissue, necessitating a personalized approach to correction.

2. Evolution of Rejuvenation Surgical Techniques

Platysmaplasty: Historical Overview

Platysmaplasty is a key surgical procedure for neck correction, having evolved over the decades:

  • - 1928: J. Bourguet introduced the submental incision for platysma correction
  • - 1978: J. Guerrero-Santos developed lateral platysma fixation,
  • - 1990: J.J. Feldman presented the "corset" platysmaplasty concept,
  • - 2005: V.C. Giampapa advanced the suspension platysmaplasty technique,
  • - 2018: C. Le Louarn modified the "hyo-neck lift" approach with platysma fixation.

Anterior (Medial) and Lateral Approaches

Medial Platysmaplasty

This method involves liposuction and approximation of the platysmal edges along the midline, often combined with adipose tissue removal. It is ideal for patients with mild to moderate neck laxity. 

Lateral Platysmaplasty

This technique employs lateral tightening of the platysma, frequently combined with facelift procedures. Advantages include minimal visible scarring and faster recovery times.

Sub-platysmal Corrections

For more pronounced changes, additional corrections may be applied:

  • - Submandibular Gland Excision: Indicated in cases of hypertrophy,
  • - Resection of Digastric Muscle Segments: To enhance the cervicomental angle,
  • - Liposculpture: For precise contouring of the neck.

3. Contemporary Trends and Combined Methods

Modern practices increasingly integrate surgical and non-surgical methods to enhance outcomes and reduce recovery time. Innovations include:

  • Laser-Assisted Techniques: For precise dissection and reduction of postoperative edema
  • Ultrasound-Assisted Methods: For selective adipose tissue removal
  • Combination of Facelift and Neck Lift Procedures: To achieve harmonious results

Conclusion

Aesthetic neck surgery continues to evolve, with the choice of optimal technique depending on patient anatomy and the degree of changes present. Modern surgeons combine minimally invasive and traditional methods to ensure a natural appearance and long-term results.

For the best outcomes, it is crucial to individualize the approach, utilize innovative technologies, and provide comprehensive postoperative care.

Be sure to visit our blog for more useful and handy information related to aesthetic medicine and cosmetology!

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