Sternohyoid muscles plication and sternocleidomastoid muscles rejuvenation in neck lift: a retrospective study of 1,019 consecutive patients

Aim: Improving the cervical contour is one of the main goals of patients seeking face and neck rejuvenation. However, little attention has been dedicated to refine the anterior border of the sternocleidomastoid muscles and to improve the inferior neck. In this study, the authors sought to describe new surgical tactics to address these issues.Methods: The records of 1,019 patients were evaluated retrospectively. Surgical strategies to treat the neck were reviewed and two new approaches, described. Plication of the sternohyoid muscles and lateral plication of the platysma along the anterior border of the sternocleidomastoid muscles are detailed and supplemented with a video.Results: Of the 1,019 patients, 937 patients (91.9%) underwent subplatysmal neck lift. Three-hundred-and-forty-eight patients (34.1%) underwent sternohyoid muscles plication, and 784 patients (76.9%) had rejuvenation of the sternocleidomastoid muscles. The most common complication was weakness of the lower lip depressors [79 patients (7.7%)].Conclusion: Approaching the sternohyoid muscles and rejuvenating the sternocleidomastoid muscles are new reliable and effective tactics to optimize results in neck lifts

Innovative Tactic in Submandibular Salivary Gland Partial Resection

Summary: Adequate neck contour is one of the goals in facial rejuvenation. In some patients, treating the submandibular salivary gland (SMSG) ensures a satisfying result. Hematoma, sialoma, and paralysis of the depressors of the lower lip may occur when the deep neck is approached. The objective of this work is to present a new tactic to prevent the aforementioned complications. Two hundred forty consecutive neck lift patients with partial resection of the SMSG were studied. The tactic consisted of placing sutures to facilitate the retraction of the platysma muscle and the accompanying marginal mandibular and cervical branches of the facial nerve during the resection of the SMSG. It also included stitches that bring the platysma muscle in contact with the remaining SMSG, sealing the dissected area. The first 25 (control) subjects did not undergo the tactic; the remaining 215 (study group) did. The occurrence of paralysis of the depressors of the lower lip and of hematoma and sialoma originating from the SMSG resection was observed. When comparing the control group with the study group, the rates of hematoma (8% vs 0%) and sialoma (24% vs 0%) were significantly higher in the former. Paralysis of the depressors of the lower lip also had a higher rate in the control group (4% vs 0.9%) although this difference was not statistically significant. The surgical tactic described is efficient in preventing the occurrence of hematoma, sialoma, and paralysis of the depressors of the lower lip in neck lift with partial resection of the SMSG