Description

Background: Short-neck morphology with a low hyoid position represents one of the greatest challenges in cervicofacial rejuvenation, often resistant to conventional lifting vectors. Achieving structural and perceptual elongation requires deep anatomical modification of the platysma and related subplatysmal structures. Objectives: To describe and evaluate a comprehensive technique combining complete platysma transection, hyoid fasciotomy, and composite flap repositioning with controlled vector fixation for cervical elongation in short-neck patients. Methods: Between May 2023 and June 2024, 167 patients underwent deep plane facelift with deep neck lift; 95 met the Auersvald criterion for short neck (neck–clavicle ≤24% of vertex–clavicle height). The procedure included subcutaneous dissection to the SC line, selective reduction of subplatysmal fat, SMG, and digastric muscle, medial platysma plication, total platysma transection below the hyoid, and vector-controlled redraping: vertical fixation of the superior segment (Mastoid Crevasse) and oblique suspension of the inferior composite flap with cable sutures.(Bravo) Results: Objective analysis showed a mean PANL ratio of 2.49 ± 0.11 (149% elongation, p < 0.001). The mean cervicomental angle improved from 118° to 92°. Blinded visual analysis revealed a 16-year mean perceived age reduction, with 93.7% rated 4/4 for elongation. FACE-Q results demonstrated 94.7% “very satisfied,” 100% natural appearance, and improved quality of life. Complications were minimal (4.3% neuropraxia, 3.1% sialoma). Conclusions: Complete platysma transection and composite flap repositioning produce both structural and optical cervical elongation, reducing platysmal tension and redefining cervicomental harmony in short-neck patients with high safety and reproducibility.

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  Scientific Papers

Additional Info

Full Abstract Link:
https://static.coreapps.net/aesthetic26/html/aboutApp_100_1295.pdf