Submental surgery. A graduated approach to the aging neck.

Adequate aesthetic contouring of the aging neck often presents a difficult surgical challenge to the facial plastic surgeon. The apparent failure of the classic rhytidectomy to achieve acceptable results in the submental region has encouraged previous surgeons to develop surgical techniques specifically addressing this area. Definitive procedures were developed to treat the excess skin, fat, or muscle. Aesthetic results have progressively improved with the introduction of liposuction, judicious muscle rearrangement, and more conservative submental skin violation. This article describes our experience with these concepts and presents a useful classification devised to serve as an operative guide in the management of the aging neck.