Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
J Cosmet Dermatol. 2021 Nov;20(11):3603-3609. doi: 10.1111/jocd.14001. Epub 2021 Mar 7.
Restoration of an esthetic neck contour is an integral component of facial rejuvenation. The corset platysmaplasty and the suture suspension neck lift were introduced by Feldman in 1990 and by Giampapa in 1995, respectively. Both techniques are routinely used in current practice with satisfactory and long-lasting results. However, some patients who have undergone the suture suspension platysmaplasty report long-term discomfort, excessive neck tightening, and recurrence of deformity.
To achieve an improvement in the Cervicomental (CM) angle and other parameters in patients with a difficult neck and to reduce the probability of long-term discomfort, excessive neck tightening, and a recurrence of deformity. The author developed a new technique that includes a very wide suture suspension with no interlocking. We hereby present a revised suture suspension technique-The Wide Suture Suspension Platysmaplasty.
Between the years 2015 and 2017, the senior author performed 286 face and neck rejuvenation surgeries with or without blepharoplasty. Of these cases, 35 patients with a heavy neck were chosen for the new Wide Suture Suspension Technique. This was a single surgeon retrospective cohort study. Patients were photographed in a lateral view preoperatively and 6 months postoperatively. Pre- and postoperative photographs were compared in four measured parameters: the cervicomental angle, the jowl angle, the horizontal distance between the mentum and the cervicomental angle and the vertical distance between the mentum and the cervicomental angle.
The Wide Suture Suspension Platysmaplasty resulted in pleasing esthetics, with minimal complications in patients with difficult necks. The cervicomental angle decreased by 42° (P < .0001), the jowl angle increased by 12° (P < .0001), the horizontal distance between the mentum and the cervicomental angle rose by 12.4% and the vertical distance between the mentum and the cervicomental angle was reduced by 34.5%.
The Wide Suture Suspension Platysmaplasty resulted in improved esthetics, as demonstrated by objective measurements. None of the patients in this series had any secondary intervention during the follow-up period. Particularly in the case of a difficult neck, surgeons should consider this technique.
恢复美观的颈部轮廓是面部年轻化的一个组成部分。Feldman 于 1990 年引入了紧身胸衣式颈阔肌成形术和缝线悬吊颈部提升术，Giampapa 于 1995 年引入了缝线悬吊颈阔肌成形术。这两种技术目前在临床中常规应用，效果满意且持久。然而，一些接受缝线悬吊颈阔肌成形术的患者报告长期不适、颈部过度紧绷和畸形复发。
改善颈部较难处理的患者的颈颌（CM）角和其他参数，并降低长期不适、颈部过度紧绷和畸形复发的概率。作者开发了一种新的技术，包括非常宽的无锁结缝线悬吊。我们在此介绍一种改良的缝线悬吊技术——宽缝线悬吊颈阔肌成形术。
在 2015 年至 2017 年期间，高级作者对 286 例面部和颈部年轻化手术进行了手术，其中包括或不包括眼睑成形术。在这些病例中，选择 35 例颈部较难处理的患者进行新的宽缝线悬吊技术。这是一项由单一外科医生进行的回顾性队列研究。患者在术前和术后 6 个月以侧位拍摄照片。比较术前和术后四张照片的四个测量参数：颈颌角、下颌角、下颌与颈颌角之间的水平距离以及下颌与颈颌角之间的垂直距离。
宽缝线悬吊颈阔肌成形术在颈部较难处理的患者中产生了令人满意的美容效果，且并发症最小。颈颌角减小了 42°（P<0.0001），下颌角增加了 12°（P<0.0001），下颌与颈颌角之间的水平距离增加了 12.4%，下颌与颈颌角之间的垂直距离减少了 34.5%。
宽缝线悬吊颈阔肌成形术通过客观测量得出了改善的美容效果。本系列中没有任何患者在随访期间需要进行二次干预。特别是在颈部较难处理的情况下，外科医生应考虑这种技术。
