Neck Rejuvenation Without Periauricular Scars.

BACKGROUND: Neck rejuvenation remains a surgical challenge due to the combined effects of skin laxity, adipose tissue accumulation, and structural and functional changes of the platysma muscle. Many traditional techniques rely on periauricular incisions, which may result in visible scars and limit patient acceptance.
OBJECTIVE: To describe an anterior neck rejuvenation technique that improves cervical contour through comprehensive liposuction, transverse platysma sectioning, and a limited submandibular platysmal corset, without periauricular incisions.
METHODS: Between 2019 and 2024, 85 patients (67 women and 18 men; age range 25-68 years) underwent this procedure, with a minimum follow-up of 12 months. All patients were treated using a standardized surgical protocol that included wide anterior skin release, supraplatysmal liposuction, selective subplatysmal fat resection, partial transverse platysma myotomy at the level of the hyoid bone with lateral extension tailored to individual anatomy, midline suprahyoid platysmal plication forming a horizontal corset limited to the submandibular region, and posterior skin redistribution without periauricular excisions.
RESULTS: The procedure resulted in significant improvement in mandibular definition, cervicomandibular angle, and vertical neck length. Complications were limited and included three seromas treated with needle aspiration and three transient mental nerve paresthesias that fully recovered within weeks. No reoperations were required. Overall patient satisfaction was high, with a mean score of 4.5 out of 5.
CONCLUSION: This technique represents a reproducible alternative for selected patients seeking isolated neck rejuvenation while avoiding periauricular scars. Although it does not replace a cervicofacial lift, it offers natural and predictable improvements with low morbidity and preserves the option for future facial surgery.
LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .