Deep neck surgery in deep plane facelifts – learning from evidence and experience

Abstract

Deep plane facelifts have gained popularity for their natural and long-lasting results, prompting increased focus on advanced neck rejuvenation techniques. Both clinical experience and literature support refined strategies to address platysmal laxity, glandular prominence, and fat distribution. Midline corset platysmaplasty and lateral platysma repositioning improve structural support and jawline definition. Novel plication methods, including purse-string, crisscross, and layered sutures, enhance durability and patient satisfaction. Submandibular gland reduction, subplatysmal fat excision, and selective myotomies targeting the digastric and sternocleidomastoid muscles further contribute to cervicomental contouring. Adjunctive procedures such as fasciotomies improve tissue mobility and complement deep-plane dissection. Collectively, these innovations yield high patient satisfaction and sustained aesthetic outcomes. As surgical precision and technology evolve, individualized, anatomy-driven approaches will remain central to optimizing neck rejuvenation.