Submental Region Research Articles

Bilateral, symmetrical, tripartite variation of the anterior belly of digastric muscle

BackgroundThe anterior and posterior bellies of digastric muscle act to facilitate components of phonation, jaw opening, and hyoid bone stabilization during swallowing. Variations in the digastric muscle within the submental triangle are well-documented in the literature. Ongoing and up-to-date reporting and knowledge of these variations is important from a clinical perspective. MethodRoutine human anatomical dissection of the anterior neck in a male donor revealed bilateral pairs of accessory muscles (n = 4) attached to and within the depth plane of right and left anterior bellies of digastric muscles. ResultsThe case presented here is of a bilateral, tripartite digastric muscle variation within the submental triangle of an anatomical donor. Attachments and relationships were noted. Variant digastric muscles were found to be innervated by the nerve to the mylohyoid muscle and supplied by the submental artery, consistent with supply to the anterior belly of the digastric muscle. ConclusionThe clinical relevance of these additional muscles primarily pertains to radiological evaluation and reconstructive surgical procedures in the submental region, as digastric muscle bellies serve as essential landmarks and potential targets. Describing anatomical variations is crucial for appropriate planning of interventions in this region.

Methodological Procedures to Acquire and Analyze Ultrasound Images of Swallowing: A Scoping Review.

This scoping review aimed to identify methodological procedures for acquiring and analyzing ultrasound images related to swallowing in adults and older adults. The inclusion criteria were based on the PCC strategy (participants, concept, and context), as follows: population (adults and older adults), concept (ultrasound assessment), and context (swallowing assessment). The review included observational, experimental, descriptive, and analytical studies and excluded those that were not available in full, animal studies, in vitro studies, letters to the editor, errata, study protocols, and those that used ultrasound for purposes other than swallowing. There were no language and time restrictions. Two independent blinded professionals selected 81 articles that met the inclusion criteria from different databases. The most evaluated parameters included tongue morphology and movements, hyoid bone displacement, swallowing muscle area, and pharyngeal residue detection, such as pharyngeal wall mobility. They used convex and linear transducers (3MHz to 8MHz) positioned in the submental, laryngeal, and lateral regions of the neck. The subjects were seated and instructed to eat different food volumes and consistencies. The literature mapping showed that ultrasound is a promising diagnostic tool, helping clinicians understand swallowing disorders, as it provides static and dynamic images in different modes and positions. Also, patients receive real-time biofeedback of changes related to dysphagia.

Submental Artery Perforator Flap Drained Solely With the Vena Comitans of Facial Artery.

The submental artery perforator flap (SMAPF) is an alternative to reconstruct oral and maxillofacial defects secondary to oral cancers. However, vascular anomalies or surgical damage often lead to vascular crises or harvest failure. Our clinical findings suggest that the vena comitans of the facial artery (cFA) very commonly exist. This study aimed to investigate the reliability of the cFA as a sole venous reflux route for the SMAPF. The patients were from the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University. All patients were treated for oral cancer between January 2016 and September 2022. Seventeen SMAPFs were successfully raised to reconstruct the postoperative defects, of which 7 had cFA as the sole reflux route. The size of the flaps varied from 4.0×3.0cm to 12.0×3.0cm. All flaps survived. Patients were followed from 1 month to 5 years. Satisfactory restoration of contour and functional outcomes were achieved at the recipient sites. The scars were well camouflaged in the submental region. No local or regional recurrence was detected during follow-up. Patients had an overall 2-year survival rate of 100% with no suspected flaps-related recurrence. The cFA as the sole venous reflux route for SMAPF is reliable for flap harvesting and is applicable for immediate defect reconstruction secondary to cancer resection.

Using Sequence Analyses to Quantitatively Measure Oropharyngeal Swallowing Temporality in Point-of-Care Ultrasound Examinations: A Pilot Study.

(1) Background: Swallowing is a complex process that comprises well-timed control of oropharyngeal and laryngeal structures to achieve airway protection and swallowing efficiency. To understand its temporality, previous research adopted adherence measures and revealed obligatory pairs in healthy swallows and the effect of aging and bolus type on the variability of event timing and order. This study aimed to (i) propose a systemic conceptualization of swallowing physiology, (ii) apply sequence analyses, a set of information-theoretic and bioinformatic methods, to quantify and characterize swallowing temporality, and (iii) investigate the effect of aging and dysphagia on the quantified variables using sequence analyses measures. (2) Method: Forty-three participants (17 young adults, 15 older adults, and 11 dysphagic adults) underwent B-mode ultrasound swallowing examinations at the mid-sagittal plane of the submental region. The onset, maximum, and offset states of hyoid bone displacement, geniohyoid muscle contraction, and tongue base retraction were identified and sorted to form sequences which were analyzed using an inventory of sequence analytic techniques; namely, overlap coefficients, Shannon entropy, and longest common subsequence algorithms. (3) Results: The concurrency of movement sequence was found to be significantly impacted by aging and dysphagia. Swallowing sequence variability was also found to be reduced with age and the presence of dysphagia (H(2) = 52.253, p < 0.001, η2 = 0.260). Four obligatory sequences were identified, and high adherence was also indicated in two previously reported pairs. These results provided preliminary support for the validity of sequence analyses for quantifying swallowing sequence temporality. (4) Conclusions: A systemic conceptualization of human deglutition permits a multi-level quantitative analysis of swallowing physiology. Sequence analyses are a set of promising quantitative measurement techniques for point-of-care ultrasound (POCUS) swallowing examinations and outcome measures for swallowing rehabilitation and evaluation of associated physiological conditions, such as sarcopenia. Findings in the current study revealed physiological differences among healthy young, healthy older, and dysphagic adults. They also helped lay the groundwork for future AI-assisted dysphagia assessment and outcome measures using POCUSs. Arguably, the proposed conceptualization and analyses are also modality-independent measures that can potentially be generalized for other instrumental swallowing assessment modalities.

In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement.

Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.

The importance of portable ultrasound in neck fat assessment and treatment

Obesity can lead to excessive neck fat, affecting aesthetics and respiratory function. Accurate assessment of fat location is crucial for treatment selection. Portable ultrasound offers real-time, dynamic imaging of the submental region, allowing for precise evaluation of the fat deposit and underlying muscle. High-frequency linear array transducers with frequencies ranging from 7 to 15 MHz are typically used. If the majority of the fat deposit is above the platysma muscle, liposuction may be recommended. Deep neck surgery may be necessary if the fat deposit is below the muscle. Portable ultrasound offers numerous benefits, including real-time imaging, non-invasiveness, absence of radiation exposure, and office setting availability. It can also monitor treatment progress and effectiveness. Accurate assessment of neck fat anatomy is vital for choosing the right treatment approach, and portable ultrasound is an essential tool in achieving optimal cosmetic and functional outcomes.

Palposcydmus gen. n. from India, with a preliminary key to world genera of Stenichnini (Coleoptera, Staphylinidae, Scydmaeninae)

Palposcydmus yelamalai, gen. et spec. n. is described, based on specimens collected in Kerala, India. The new species is one of the smallest known scydmaenines, with the body length reaching merely 0.53–0.59 mm. Although in dorsal aspect resembling Microscydmus Saulcy &amp; Croissandeau, Palposcydmus clearly differs in the presence of hypostomal sutures demarcating a subrectangular submental region, and enormously enlarged maxillary palpomeres 3. The new genus shows also a unique antennal structure not known in any other Stenichnini: the antennomere 3 is inserted deeply into the apex of pedicel, so that there is no constriction between them. Keys to extant genera of Stenichnini are given, in order to facilitate identifications separately to Indian, Eurasian &amp; New Guinean, and to world genera.

Deep Neck Lifting.

Creating tight and durable profile neck results has perhaps become the principal objective of many surgeons. On social media such results are quickly recognized by colleagues and potential clients alike, much more so than "en-face" results. Yet individual patient characteristics play an essential role in determining if such results are technically possible and also dictate which techniques are required to achieve it. In many patients, these techniques involve manipulation of the deeper neck structures and are oriented more laterally than the direct submental region. Each surgeon needs to decide which technique feels proportionate in terms of an individualized risk-benefit analysis.

Relationship Between Submental Superficial Layer Hardness and Tongue Pressure Determined Using a Tissue Durometer.

Aging affects the tongue and suprahyoid muscles, causing dysphagia and undernutrition. We hypothesized that tongue function would affect submental superficial layer hardness. Tongue movements during water retention between the tongue and palate are the same as those required during bolus formation, involving internal and external tongue muscle movement. In 28 healthy adults (14 males, 14 females, average age 28.7 ± 2.9 years), we measured the submental superficial layer characteristics (frequency [tension], stiffness, decrement [inverse of resilience], relaxation, and creep [deformation over time]) using a simple tissue durometer (MyotonPRO®), and examined their relationship with maximum voluntary tongue pressure. The tissue durometer sensor was placed in the submental region, where there is no intervening bone. Measurements were performed at rest and while retaining 5 mL water. Tongue pressure was measured using a tongue pressure-measuring device. The submental superficial layer hardness differed significantly between rest and during water retention. During water retention, frequency and stiffness were high, while decrement, relaxation, and creep were low. When pressure is applied to the palate, such as during water retention the inner tongue muscle, which changes the tongue's shape, and the outer tongue muscle, which moves the tongue laterally, are active. However, the change in the hardness of the submental superficial layer during water retention may be related to the suprahyoid muscles that are present in this layer. The results of this study suggested that the hardness of the submental superficial layer changed during water retention, and that tongue movement could be measured from outside the mouth.

Large Epidermoid Cyst in Submental Region: A Rare Case Report

Epidermoid cyst, specially in large size is one of the rare lesions of maxillofacial region, affects submental and sublingual region. The cyst develops from the entrapment of pluripotent ectodermal and mesodermal primordia, in the embryonic lines of fusion, when first and second branchial arches of each fuse in the midline, between third and fourth weeks of intrauterine life. After entrapment, this tissue shows gradual proliferation and ultimately transform to a cyst. A 19-year-old-boy presented with such a midline painless large swelling in the submental and sublingual region with diagnosis of epi dermoid cyst. After enucleation, the patient didn’t show any recurrence after 2 years follow up. J Bangladesh Coll Phys Surg 2024; 42: 92-96

Expansion of Renuvion Application to Areas Beyond the Submental Region: Review and Experience.

Minimally invasive and consistent skin redraping following liposuction remains an elusive goal. With the application of Renuvion (Apyx Medical, Clearwater, FL), helium induced cold atmospheric plasma provides coagulation, collagen contraction, and subsequent skin tightening, making this elusive goal attainable. The objective of this study is to evaluate energy settings, and the safety profile of Renuvion in an effort to achieve optimal cosmesis through the improvement of skin laxity. A retrospective review at a single site evaluated cases of Renuvion between March 2020 and May 2022. Energy settings, use of concomitant VASER (Solta Medical, Bothwell, WA) liposuction frequency, and adverse events were analyzed. In total, 180 patients were evaluated, of whom 135 (75%) underwent concomitant VASER liposuction. Renuvion was used on the abdomen (47.8%), thighs (45.6%), arms (27.2%), submental region (25%), hip rolls (21.2%), and back (19.4%). Among the entire cohort, there were a total of 24 (13.3%) complications. The complications consisted of 3 (12.5%) hematomas, 1 (4.2%) burn, 6 (25%) persistent skin laxity with 2 returned operating room (OR) treatments, 4 (16.7%) seromas, 9 (37.5%) postoperative lymphedema that self-resolved, and 1 (4.2%) self-limited neuralgia. There were no complications that required an immediate return to the OR. Renuvion utilization with or without VASER has a relatively high complication rate-with minor complications as the most common-relatively safe barring proper patient selection, which can be mitigated with proper patient selection.

Orthodontic Treatment and Mini Wing Osteotomy: A Case Report of Changes in Facial Aesthetic

For correction of dentofacial deformities, orthosurgical treatment is recommended and often involves bi-maxillary orthognathic surgery. The chin area is an important key for a harmonious facial profile and plays an important role. The present case (of a 38- year-old female) describes one successful surgical-orthodontic treatment. The treatment consisted of the use of an Edgewise fixed appliance (0.022”×0.028”), mini Wing osteotomy (mWo), correction of the deviated nasal septum, and rhinoplasty. The treatment resulted in a better facial harmony and aesthetic with greater definition and lengthening of the submental region, adipose tissue elimination, and an upturned nose due to the correction of the deviated nasal septum associated with rhinoplasty. The Class I canine and molar relationship, the upper and lower midlines coincident with the facial midline, and the compensatory projection of the lower incisors were maintained. A satisfactory overbite and overjet, and leveled curve of Spee were obtained. In conclusion, the orthodontic treatment associated with mWo, correction of the deviated nasal septum, and rhinoplasty surgery provided satisfactory functional and aesthetic results.

TRAUMATISME CERVICO-FACIAL PAR BARRE DE FER : A PROPOS DE DEUX CAS PEDIATRIQUES

objective: Head and neck trauma is common in ENT emergencies. The severity depends on the area of impact, the causal object and the injuries caused. We report two cases of head and neck trauma secondary to an iron bar caused by a playful accident.observation 1: 12-year-old boy received for penetrating neck wound with an iron bar, affecting sectors 2 and 3 with entry point at the left subdigastric region and exit point at the ipsilateral mastoid region. The exploratory cervicotomy did not find any major vascular lesions and allowed the extraction of the blunt object. The postoperative course was simple.observation 2: 8-year-old girl received for trauma to the mandible by a transfixing iron bar. The exploration revealed an iron bar which crossed the submental region with an exit point at the level of the floor of the mouth. The extraction was carried out without major vasculo-nervous lesions. The postoperative course was simple.Conclusion: Head and neck trauma remains a concern due to its potential seriousness and remains a medical-surgical emergency. The management of such a case must be preceded by a lesion diagnosis in order to prevent surgical surprises. Exploratory cervicotomy allows good exposure of the vascular-nervous structures. Prevention through parent education and child monitoring is essential to reduce the incidence of these injuries.

The association between C-reactive protein (CRP)/Albumin Ratio (CAR) and the outcomes of patients with Ludwig's Angina

Link of Video Abstract: https://youtu.be/bd2v_SEY08Q Background: A severe form of widespread cellulitis that affects the submandibular and submental regions is known as Ludwig's angina. The C-reactive protein/Albumin Ratio (CAR) was utilized to evaluate the prognosis of several different disorders. This research aims to evaluate the correlation between CAR and mortality as well as the outcome of patients with Ludwig's Angina. Additionally, it seeks to determine the optimal CAR ratio threshold for predicting mortality in Ludwig's Angina patients. Methods: This study presents a retrospective cohort analysis of patients diagnosed with Ludwig's Angina aged over 20 years and underwent operative treatment at RSUD Dr. Soetomo Surabaya between January 2018 and April 2023. Data were analyzed using SPSS version 23.0 for Windows. Results: 121 patients diagnosed with Ludwig's Angina were recruited for the study. In this study, most research subjects (65.4%) were male. The percentage of cases classified as mild, moderate, or severe was 5.4%, 58.5%, and 36.2%, respectively. The calculated cutoff value for CAR was determined to be 8.87. The model's sensitivity was 66%, indicating its ability to identify positive cases correctly. Similarly, the model's specificity was determined to be 66.3%, demonstrating its ability to identify negative cases correctly. The p-values for the relationship between CAR and patient outcome, severity, and length of stay (LOS) were found to be 0.001, 0.028, and 0.014 in each case. Conclusion: The C-reactive protein/Albumin (CAR) ratio, which serves as an inflammatory marker, can be utilized to evaluate the mortality rate associated with Ludwig's Angina. This tool can stratify patients diagnosed with Ludwig's Angina.

Emergency Management of Symphysis and Right Angle of Mandible Fracture with Laceration Wound at Buccal and Submental Region: A Case Report

Introduction: Fracture of the mandible is a case that is quite commonly found in the ER of The Oral and Maxillofacial Surgery Department at Dr. Hasan Sadikin General Hospital Bandung, fractures of the mandible rank second to fractures of the facial area because it is a prominent bone that is located at the edge and position in the lower third of the face. Emergency management aims to take any appropriate action, prevent complications, and consult other departments involved. Objective: To explain the emergency management of symphysis and right angle of mandible fracture with laceration wound at buccal and submental region. Case report: A manage 21 year came with bleeding from the mouth due to a motorcycle accident approximately 24 hours before admission to the hospital. Physical examination showed asymmetrical face, edema at right cheek region, laceration wound at right cheek and chin region, and multiple abrasive wound at facial region. There were steps, crepitus on symphysis, and right angle of mandible region. Intraoral examination showed laceration wounds on the gingiva. Case management: The laceration area is then sutured both intraoral and extraoral followed by the application of closed reduction in the mandible with interdental wiring at the lower jaw aiming to prevent infection and malunion. The management of soft tissue and hard tissue injury is by reduction, fixation, and immobilization of fractures, management of pain, and administration of antibiotics. Conclusion: The emergency management of symphysis and right angle of mandible fracture with laceration wound at the buccal and submental region is promptly and rapidly carried out with minimal intervention by using closed reduction method gave good results in stability and function before definitive treatment.

Papillary Thyroid Carcinoma within a Thyroglossal Cyst: A Rare Case Report with Review of Literature.

Thyroglossal cyst (TGC) is the most common congenital anomaly of the thyroid gland and is found in approximately 7% of general population. It represents cystic degeneration of a remnant of the thyroglossal duct that failed to involute during gestation. Malignancy occurring in TGC is rare entity, accounting only for 1% of all thyroglossal cysts. We are presenting such a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst.30-year-old female presented with a painless, gradually progressive swelling below the chin extending to left side. On examination, swelling was noted in submental region and measuring 4 × 3 × 1cm, firm in consistency and moves with deglutition and movement of tongue.On radiological investigations, lobulated cystic lesion in midline with thin septations was seen, suggestive of thyroglossal cyst. The thyroid of the patient was normal. Patient underwent Sistrunk procedure. On histopathology, papillary thyroid carcinoma in thyroglossal cyst was seen and it was invading cyst wall and superficial skeletal muscle.The 1st case of thyroglossal duct carcinoma was reported by Brentano in 1911. Till now 300 cases have been reported in literature. Carcinomas occurring in thyroglossal cyst are extremely rare, (< 1% cases). The most frequent histological type is papillary pattern followed by mixed(papillary and follicular), squamous cell, Hürthle cell, follicular and anaplastic variety. The etiology of thyroglossal duct carcinoma is unknown and neither good clinical history nor examination can lead to a preoperative diagnosis. Diagnosis is often incidental on histopathology as in present case.Thyroglossal duct carcinoma is a rare condition that comes as a surprise to both the patient and surgeon and should be considered in patients presenting with cystic midline neck masses.

Morphological study of the anatomical variations of anterior belly of digastric muscle in Brazilian cadavers.

Cases of variations in anterior belly of the digastric muscle must be carefully identified to avoid misinterpretations and assist in the correct surgical or aesthetic procedure and help in the teaching of anatomy. The aim of this study was to describe the anatomical variations of anterior belly of digastric muscle in Brazilian cadavers. Thirty-one human heads were selected, from adult cadavers (18-80 years, 29 males and 2 females). The morphology of the anterior belly of the digastric muscle was observed, identifying the possible anatomical variations that were characterised and classified according to the amount of muscle bellies, fibre direction and place of origin and insertion. The morphometric measurements were performed using a digital calliper. To analyse the data obtained, photographic documentation, anatomical description and individual morphometric description of each muscle belly were performed. The incidence of anatomical variation was obtained in percentage (%). The anatomical variation of the anterior belly of the digastric muscle was present in 6 cadavers (19.31%; 1 female and 5 male). All anatomical variations presented an accessory belly to the anterior belly. However, these accessory bellies were configured differently in the location, direction of muscle fibres and in their dimensions (length and width). The gross anatomy of the anterior belly of the digastric muscle and their variations is important to assist in surgical procedures, pathological or diagnostic function. In addition, asymmetrical variations in the submental region must be carefully identified to avoid misinterpretations.

Management of Giant Cell Tumor of the Hyoid bone- A rare Clinical Entity with Review of Literature.

Giant cell tumors (GCTs) are typically found in the long bones but can also occur in the head and neck region. GCT of the larynx is a rare entity with only 42 reported cases in the international literature. Furthermore, to the best of our knowledge this is the largest laryngeal GCT reported in the literature to date. GCT of the larynx can present with dysphonia, dyspnea, and/or dysphagia and should be considered in the differential diagnosis of a neck mass. A38-year-old man presented with complaints of mass in the neck with dysphonia and dysphagia. On clinical examination,there was huge spherical swelling extending from submental region till sternal notch with overlying normal skin. Computed tomography (CT) neck revealed a 20 × 15.7cm mass centered on the hyoid bone, which was further diagnosed by histopathology as giant cell tumour on biopsy. The patient was counselled on treatment options and it was decided to proceed with a surgical approach. The patient consented to and successfully underwent en-bloc excision of mass with hyoid bone. Histopathology report revealed GCT of Hyoid bone.Currently the patient has no evidence of disease at 25 months follow-up, has an optimal voice, and is on regular follow -up with us. GCTs of the larynx have a good prognosis and can be treated successfully through complete resection of the tumor, negating the need for adjunctive therapy such as radiation, chemotherapy or denosumab therapy.

Topographic anatomy of the submental artery and its clinical implications for reconstructive surgery.

Knowledge about the anatomy of the submental artery (SA) is of immense importance when performing plastic and reconstructive procedures. A retrospective study was performed to analyze the topographic anatomy of the SA. The measurements were performed on 80 consecutive patients who underwent head and neck computed tomography angiography (CTA). The SA was present in 131 out of 137 hemifaces (95.6%). The vessel originated from the facial artery in all cases (100.0%). Moreover, the SA was found to have 0-4 branches. However, most commonly, the said artery had no branches of considerable size (51.1%). Due to the high variability of the course of the said artery, the authors of the present study created a novel classification system presenting the most prevalent courses of the SA in the submental region. The current study utilized 131 hemifaces of 80 (CTA) to create a heat map of the SA, illustrating its precise origin and course in the submental region. The findings of this study could assist surgeons in developing a mental map of the arterial anatomy of the submental region, potentially improving the efficiency of localizing the SA and reducing the risk of complications during plastic and reconstructive procedures.

1470 Nm Diode Laser Effectiveness in Facial Fat Reduction with the Endolifting Technique: Pilot Study

Introduction: Endolifting technique, also known as Endolaser or Endolift, consists of using a laser beam with a wavelength of 1470 nm emitted through an optical fiber inserted into the subdermal tissue in order to reduce subcutaneous fat and tone the skin through the intense production of collagen. Objective: This study aimed to collect preliminary results about the effectiveness of the 1470 nm diode laser in reducing facial fat with the endolifting technique. Material and methods: 10 patients were assisted with just one endolifting session, where the mandibular and submental regions were treated. It was by using 400 micron optical fiber, power ranging from 4 to 8 W, in continuous mode. After the procedure, patients were instructed to remain with a bandage on the treated area for 4 days and. Then, after this period they received 4 sessions of manual lymphatic drainage, which was performed once a week. Results: After treatment and reassessment at the end of 60 days, it was noticed a clear decrease in fat in the cheeks, as well as in the submental region. Also, the skin where the jowl fat was removed underwent intense retraction, as it was seen a decrease in flaccidity and wrinkles. Conclusion: It was concluded that the endolifting technique is extremely effective in promoting the reduction of unsightly subcutaneous fat on the face and neck, as well as indirectly intervening in the skin to promote rejuvenation to varying degrees. Likewise, this technique can be attested as a safe method due to the absence of complications or intercurrences throughout the care and follow-up of patients after treatment.