Chinta Sachin R, Brydges Hilliard T, Laspro Matteo, Shah Alay R, Cohen Joshua, Ceradini Daniel J
From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY.
Ann Plast Surg. 2025 Feb 1;94(2):222-228. doi: 10.1097/SAP.0000000000004163. Epub 2024 Dec 3.
The aging neck is a prevalent aesthetic concern, with over 160,000 neck procedures performed in 2020. It is characterized by increased soft tissue laxity and displacement of cervical structures. While nonsurgical interventions like cryoablation and laser resurfacing show promise, their variable responses highlight the necessity for surgical solutions. Traditional neck lifts address superficial structures but often neglect the subplatysmal plane. Recently, deep plane neck lifts have gained attention for addressing deeper anatomical structures. This paper systematically reviews the literature on subplatysmal modifications in cervicoplasty, aiming to clarify the risks and benefits of these evolving surgical techniques.
On February 20, 2024, a systematic review adhering to Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 guidelines was performed. MEDLINE, PubMed, Cochrane, and Scopus databases were searched for terms related to neck rejuvenation. Independent reviewers screened titles, abstracts, and full texts, including all relevant studies. Data extracted included patient numbers, procedures, outcomes, and complications.
From an initial 771 articles, 57 studies encompassing 8648 patients met inclusion criteria. The most commonly altered anatomical structures during "deep plane" neck lift (DPNL) were the submandibular gland (69.9%), digastric muscles (58.6%), and subplatysmal fat (48.6%). Postoperative complications were reported in 59.6% of studies, with nerve palsy (0.2%-12%) and hematoma (0.2%-4%) being most common. Aesthetic outcomes were less frequently reported (56% of studies); patient satisfaction ranged from 81.6% to 98.6%, while objective measures were reported in only 12% of studies.
Recent surveys indicate a growing concern over excess laxity under the chin, with patients increasingly seeking neck rejuvenation. Our review found that DPNL techniques vary widely, with the submandibular gland and digastric muscles being the most frequently altered structures. Despite a general lack of standardized outcome measures, patient satisfaction was high. However, DPNL showed a higher rate of postoperative nerve palsy compared to traditional neck lift. Overall, while DPNL demonstrates potential aesthetic benefits, the increased risk necessitates thorough patient counseling and further studies for standardization and comparison.
颈部老化是一个普遍存在的美学问题，2020年有超过16万例颈部手术。其特征是软组织松弛加剧和颈部结构移位。虽然冷冻消融和激光换肤等非手术干预措施显示出前景，但它们的不同反应凸显了手术解决方案的必要性。传统的颈部提升术处理的是浅表结构，但往往忽略了颈阔肌下平面。最近，深层平面颈部提升术因处理更深层的解剖结构而受到关注。本文系统回顾了有关颈部整形术中颈阔肌下改良的文献，旨在阐明这些不断发展的手术技术的风险和益处。
2024年2月20日，按照《系统评价和Meta分析的首选报告项目2020》指南进行了一项系统评价。在MEDLINE、PubMed、Cochrane和Scopus数据库中搜索与颈部年轻化相关的术语。独立评审员筛选标题、摘要和全文，包括所有相关研究。提取的数据包括患者数量、手术、结果和并发症。
从最初的771篇文章中，57项研究（涵盖8648名患者）符合纳入标准。在“深层平面”颈部提升术（DPNL）中最常改变的解剖结构是下颌下腺（69.9%）、二腹肌（58.6%）和颈阔肌下脂肪（48.6%）。59.6%的研究报告了术后并发症，其中神经麻痹（0.2%-12%）和血肿（0.2%-4%）最为常见。美学结果的报告较少（56%的研究）；患者满意度在81.6%至98.6%之间，而只有12%的研究报告了客观测量结果。
最近的调查表明，人们对下巴下方过度松弛的担忧日益增加，患者越来越多地寻求颈部年轻化。我们的综述发现，DPNL技术差异很大，下颌下腺和二腹肌是最常改变的结构。尽管普遍缺乏标准化的结果测量方法，但患者满意度较高。然而，与传统颈部提升术相比，DPNL术后神经麻痹的发生率更高。总体而言，虽然DPNL显示出潜在的美学益处，但风险增加需要对患者进行充分的咨询，并进行进一步的标准化和比较研究。
