Dallas, Texas; and Coconut Grove, Fla. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, and private practice.
Plast Reconstr Surg. 2013 Aug;132(2):339-350. doi: 10.1097/PRS.0b013e3182958b6f.
A harmonious and youthful appearing neckline is arguably the most vital aspect of a successful facial rejuveation. Without sound principles, the neck appears skeletonized, tethered, and hollow. The anatomical studies that the authors have performed regarding the neck, jowl, and subplatysmal elements have influenced the techniques that they now use. The authors' approach modifies the classic techniques of the past, and seeks a nuanced approach to each patient by resuspension and reshaping of deeper neck elements.
In this article, the authors apply their anatomical research and cadaveric studies to demonstrate and support their neck-lift techniques. The authors integrate their knowledge to describe how the technique of one of the senior authors (R.J.R.) has evolved over time.
The main tenets of the authors' approach have evolved into a sequence that involves skin undermining over the neck and cheek, submental access to the neck, with possible excision of fat and midline plication of the platysma with release of the muscle inferiorly, platysmal window suspension laterally, precise release of the mandibular septum and ligament if needed, and finally redraping of the superficial musculoaponeurotic system (SMAS) by plication or SMASecomy. These five steps ensure correction of jowling, a smooth jawline, and a well-shaped neck.
The five-step neck lift helps to optimize results in creating the ideal neck contour. The authors provide four points that should be considered in any neck-lift procedure. The end result is a well-defined, well-contoured neck, with an approach grounded in sound anatomical principles.
和谐、年轻的颈线是成功面部年轻化最重要的方面。如果没有正确的原则，颈部会显得憔悴、紧绷和凹陷。作者进行的有关颈部、下颌和下颌下区的解剖学研究影响了他们现在使用的技术。作者的方法修改了过去的经典技术，并通过重新悬吊和重塑深层颈部元素，对每个患者采用细致入微的方法。
在本文中，作者应用他们的解剖学研究和尸体研究来展示和支持他们的颈部提升技术。作者整合他们的知识来描述其中一位资深作者（R.J.R.）的技术是如何随着时间的推移而发展的。
作者方法的主要原则已经演变成一个序列，包括颈部和脸颊的皮肤皮下剥离、颏下进入颈部，可能切除脂肪和中线颈阔肌折叠，同时释放下方肌肉、颈阔肌窗侧悬带、必要时精确释放下颌隔和韧带，最后通过折叠或 SMAS 切除术重新覆盖浅层肌肉筋膜系统 (SMAS)。这五个步骤确保了对下颌赘肉、平滑的下颌线和良好的颈部轮廓的矫正。
五步颈部提升有助于优化创建理想颈线轮廓的效果。作者提供了在任何颈部提升手术中应考虑的四点。最终结果是颈部轮廓分明、轮廓优美，采用基于可靠解剖学原则的方法。
