Hyoid Suspension Neck Lift.

BACKGROUND: The shape of the deep cervical structures is the shape of an aesthetic neck. With age, changes can obstruct visualization of that shape. Achieving a youthful contour requires removal of excess skin and fat but also control of the platysma to allow skin to redrape like a blanket over an underlying framework. The authors' technique makes the platysma part of the deep cervical structures whose shape underlies an attractive neck and allows the skin to redrape to that contour.

METHODS: To make the platysma conform closely to the deep cervical structures and allow the skin to show that new form, the authors developed a procedure that includes removal of excess fat, attaching the platysma to the hyoid fascia, approximating the edges of the platysma above and below that suture, and wide undermining of skin to allow it to re-drape naturally over those deeper structures.

RESULTS: Over 7 years, 110 patients underwent aesthetic facial surgery that included hyoid suspension of the platysma. One patient had recurrence of platysmal bands after failure of the key suture. Complications included hematoma in three patients and submental seromas in three patients, but no permanent nerve injury, no skin loss from vascular compromise, no reported changes in vocal resonance, and no complaints of difficulty swallowing.

CONCLUSIONS: This method allows the skin to redrape over a youthful framework and produces reliable aesthetic and long lasting results. It is a simple, reproducible, teachable technique that enables surgeons to achieve results previously difficult to obtain in a single operation.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.