Suture suspension technique offers predictable, long-lasting neck rejuvination

Abstract

Vincent C. Giampapa, MD, Montclair, NJ, is a board-certified plastic surgeon. The underlying mechanisms involved in the aging neck include increased laxity in the skin, buildup of subcutaneous fat in the subdermal, submental, and preplatysmal planes, and a lack of tone and lengthening of the platysma muscle.1 Due to these factors, loss of a well-defined cervicomental angle and a decrease in the definition of the inferior mandibular border can be observed. Traditional surgical techniques focus on the redraping of the skin through preauricular incisions and the tightening or plicating of the muscle through a myriad of techniques, all which fail to achieve reliable long-term results.2–4 Key elements for long-term success with the suspension technique include proper patient selection and appropriate attention to the technical details of the procedure. The suture suspension technique is an excellent option for the patient who would like to avoid a face lift incision and whose primary signs of aging have occurred in the neck and mandibular area. It is also an excellent choice for a patient who has undergone a previous rhytidectomy with an unsatisfactory result at the level of the cervicomental angle and mandibular border. When I examine a patient with neck laxity, the first step is to check the depth of the natural cervicomental angle. This can be easily accomplished with a cotton applicator and gentle pressure. The deeper the cervicomental angle, the better suited the candidate for this procedure. A deep cervicomental angle will take up the excessive skin and muscle laxity and allow for a new neck contour with no postoperative redundancy of either of these key structures. The suture suspension technique is an excellent option for the patient who would like to avoid a face lift incision and whose primary signs of aging have occurred in …