"The stork lift": a circumoccipital extended neck-lift

The goal of the lower face- and neck-lift is restoration of a sharp cervicomental angle. However, standard cervical rhytidectomy for the patient with extensive excess skin of the neck often leaves the patient with objectionable vertical or diagonal skin folds of the lateral neck, a large hair-step deformity, or both. To remove extensive excess skin of the neck and to avoid vertical/diagonal folds and a stepped hairline, the authors "walk" the excess skin posteriorly along the hairline, often from ear to ear along the inferior posterior hairline.

Patients with extensive excess skin of the neck underwent neck-lift procedures using the circumocciput incision technique during a 1-year period. With the patient in a sitting position, a postauricular face-lift incision is extended along the inferior hairline from ear to ear. The flap is "walked" posteriorly to and along the occiput on either side of the midline. It is closed using a divide and close technique. Flaps are created, and the wound is closed in a multilayered fashion with a posterior midline A-to-T flap.

During a 1-year period, 25 patients (22 women and 3 men) underwent a cheek/neck-lift, and 2 patients (1 man and 1 woman) underwent isolated neck-lift procedures using the circumocciput incision technique. The average patient age was 64.8 years (range, 49-79 years). There were no instances of obvious lateral neck folds. Complications included hematoma (1 patient), Candida wound infection (1 patient), and a widened scar revised secondarily (1 patient). All the patients were satisfied with their cosmetic result 6 months after the operation. None of the patients stated that their final scar was noticeable or objectionable.

The patients in this study who presented with excessive redundant skin of the neck were treated with the "stork lift," which provided excellent lifting of the anterior, lateral, and posterior neck as well as excellent cervicomental angles without postoperative sequelae of lateral neck folds or stepped hairlines.