Revision Neck Lift Surgery: A Systematic Review of Indications, Techniques, and Outcomes.

BACKGROUND: Revision neck lift is among the most technically demanding facial rejuvenation procedures and often addresses complex deformities related to aging, prior operations, or inadequate management of deep neck structures. Evidence remains sparse and heterogeneous.
METHODS: A systematic review was performed in accordance with PRISMA 2020 and prospectively registered in PROSPERO (CRD420251110148). PubMed, Scopus, and Web of Science were searched without time restrictions. Studies reporting ≥5 patients who underwent revision neck lift were included. Data on demographics, indications, techniques, follow-up, and complications were extracted, and owing to heterogeneity and small sample sizes, results were synthesized descriptively.
RESULTS: Five retrospective series comprising 188 revision neck lift cases met the inclusion criteria. Among patients with reported sex, 95% were women, with reported ages between 31 and 77 years. Recurrent platysmal banding, persistent submental fullness, and submandibular gland (SMG) ptosis were the most frequently cited indications. Platysmal maneuvers were the most commonly reported revision interventions, although technique subtypes and denominators were inconsistently reported. SMG reduction was performed in 13% of patients and detailed in only one study, limiting any inference regarding indications, efficacy, or risk. Reported complications were uncommon and mainly transient, consisting primarily of transient marginal mandibular neuropraxia and isolated hematoma; no permanent nerve deficits were noted. Given heterogeneity and inconsistent reporting of complications across studies, complications were summarized descriptively without pooling.
CONCLUSION: Available case series suggest potential contour improvement after revision neck lift; however, aesthetic outcomes were predominantly qualitative and surgeon-reported, and standardized objective or patient-reported measures were rarely used.
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