Necklift through a Submental Incision: Does It Really Work?

Purpose: While necklift through a submental incision has been well described, its effectiveness is still questioned by some authors.^1-4 The goal of this study was to assess the success of the procedure in aging necks of varying severity. Additionally, we sought to determine the utility of this operation in patients with severe neck deformities including obtuse cervicomental angles and significant skin laxity.

 

Methods: A retrospective review of patients who underwent necklift through a submental approach was performed. Pre-procedure and post-procedure photographs were de-identified and then mixed randomly. The scrambled photos were examined by independent evaluators in the profile and anterior-posterior view to grade the change in cervicomental angle based on the Knize (I-IV) scale.^2-3 Evaluators were then asked to guess the patient’s age in before and after photos. The validated apparent age assessment scale was used to calculate the reduction of apparent age following surgery.⁵  

 

Results: A total of 27 patients were evaluated. Post-procedure photographs were taken at an average of 24.7 months. 42% of patients were graded as mild necks and 58% as moderate to severe necks pre-operatively. There was an average apparent age reduction of 3.6 years and 1.0 grade improvement in cervicomental angle between the pre-procedure and post-procedure photographs. When the data was isolated to the moderate to severe neck patients, there was an average apparent age reduction of 3.9 years and a 1.4 grade improvement in the cervicomental angle following surgery.

 

Conclusions: Necklift through a submental approach is an effective operation in improving the cervicomental angle and reducing the apparent age of patients by 3.6 years on average. In more severe cases, there is a 1.4 grade cervicomental angle improvement and a 3.9 year age reduction. The success of this procedure is predicated more on degree of skin laxity rather than on severity of cervicomental angle. This operation is a viable option for patients who desire neck improvement but do not want to undergo a lower facelift operation.  However, patients must be counseled that the improvement is most significant in the neck profile and is limited to below the jawline. 

 

1. Ramirez O. Cervicoplasty: nonexcisional anterior approach. Plastic & Reconstructive Surgery. 1997; 99: 1576-1585
2. Knize D. Limited incision submental lipectomy and platysmaplasty. Plastic & Reconstructive Surgery. 2004; 113: 1275-1278
3. Zins J, Fardo D. The “anterior only” approach to neck rejuvenation: an alternate to face lift surgery Plastic & Reconstructive Surgery. 2005; 115: 1761-1768
4. Zins J, Menon N. Anterior approach to neck rejuvenation. Aesthetic Surgery Journal. 2010; 30(3): 477-484
5. Ozturk C, Huettner F, Ozturk C, Bartz-Kurycki M, Zins J. Outcomes assessment of combination face lift and perioral phenol-croton oil peel. Plastic and Reconstructive Surgery. November 2013; 123(5): 743-753