Visual criteria for success in restoring the youthful neck.

We have suggested visual criteria for achieving and assessing success in platysma cervical lift. We believe it is now possible to satisfy these criteria in most patients, even those with a low-lying hyoid. Anterior adjustment of the platysma is more important for desirable results than posterior adjustment or posterior closure alone. If present in a heavy neck, the subplatysma fat pocket must be excised. A posterior submental incision as well as a more radical submental lipectomy with platysma sling (submental neck lift) is helpful for patients who are not yet candidates for an upward lift. The cutting of the platysma and fashioning of the sling, as well as defatting, may possibly add to the longevity of the lift, but this can be ascertained only by long-term follow-up.