Anterior approach to neck rejuvenation

The anterior (submental) approach to neck rejuvenation has been described by multiple authors. The efficacy of the procedure depends on adequate release of cutaneous septae and cutaneous ligaments, which allows for skin contraction without skin resection as well as subplatysmal recontouring and platysma muscle tightening. With this procedure, the greatest improvement in appearance will be seen in the profile view. No improvement will occur above the mandibular border. The degree of profile improvement correlates best with skin quality. Because no skin is removed in this procedure, skin tightening is dependent upon skin elasticity. Therefore, those patients with poor skin quality will obtain lesser results. Patients are graded with regard to skin quality from grades I to IV, with grade I patients demonstrating ideal skin elasticity and grade IV patients demonstrating poor skin quality. The technique is described in detail, potential complications are noted, and technical limitations of the procedure are described.