Long-Term Results of Suture Suspension Platysmaplasty for Neck Rejuvenation: A 13-Year Follow-up Evaluation

Abstract

Neck rejuvenation has been one of the most important components in treatment for the aging face because the neck frequently is the first feature to show signs of aging. Several techniques have been described, but assessment of the long-term effects, although limited, has shown frequent recurrence of neck ptosis and the need for reoperation. The suture suspension technique was introduced 13 years ago. This article presents the long-term results for this technique, illustrating the different neck types, their classification, and their outcomes. For this study, 100 patients who underwent neck rejuvenation using the suture suspension platysmaplasty technique were randomly selected. They represented the four patient groups examined: 5-year group (47 patients), 7-year group (28 patients), 10-year group (19 patients), and 13-year group (6 patients). The key anatomic points for each patient were evaluated preoperatively and postoperatively by five independent observers who analyzed the outcomes with a simplified scoring system (1 to 10 for each anatomic point). The scoring system was used for all the patient age groups and applied to all six key anatomic points of the neck: cervicomental angle depth, mandibular border definition, mandibular angle definition, labiomandibular fold prominence (jowling), mental prominence, and neck width. Patient satisfaction surveys were offered to all patients included in the study. All the patient groups showed significant aesthetic improvement (in terms of their scores) for all the anatomic points (1-6) evaluated. Specifically, the long-term effect of the procedure was the most impressive for the cervicomental angle (with improvement ranging from 82% to 95% for the four groups of patients). The least degree of improvement was noted for the labiomandibular fold (with improvement ranging from 12% to 53% for the four groups of patients). The remaining anatomic variables showed an overall improvement ranging from 61% to 85%. The suture suspension technique is a safe, reproducible technique that allows for a staged rejuvenation of the neck. As an alternative for the early rhytidectomy candidate, it produces excellent patient satisfaction outcomes with long-term corrections for the majority of patients. As compared with previously described platysmaplasty techniques, suture suspension platysmaplasty has the benefit of endurance. This article documents that the corrections can last at least 13 years with virtually unchanged aesthetic results.