What it means for a patient
- If you have had Kybella, CoolSculpting, radiofrequency devices or threads in the neck, tell your surgeon. These treatments can leave scar tissue that changes how a neck lift is done.
- A neck lift after these treatments may take longer and may need deeper work under the neck muscle.
- The authors report that nearly all patients in this group had some contour irregularity after surgery.
- This is one surgeon's practice over one year, with no untreated comparison group reported in the abstract.
Why this paper matters
It documents what one surgeon found inside the neck after popular nonsurgical treatments and links those findings to longer surgery and contour problems. The authors advise surgeons to plan for these changes and to counsel patients before surgery.
Overview
Injectables, fat freezing, energy devices and threads are sold as alternatives to a neck lift. The authors asked whether these treatments make a later neck lift harder. They reviewed 180 neck lifts performed in 2023 by a single surgeon, recording prior treatments, what was found during surgery, and outcomes.
Findings
- 180 neck lift procedures, one surgeon, 2023, retrospective review.
- 123 of 180 patients (68%) had prior neck treatment: surgical neck lift and/or noninvasive therapy.
- Prior treatments named: chemolipolysis (Kybella), cryolipolysis (CoolSculpting), radiofrequency-assisted lipolysis (FaceTite, Morpheus8, SmartLipo, Ultherapy, Profound), suture suspension (MyEllevate, PDO threads).
- Findings at surgery after nonsurgical treatment: fibrosis, loss of normal tissue planes, rigid platysma and deep fascia, unpredictable fat distribution.
- Deep cervicoplasty with management of structures under the platysma was required in 94% of cases.
- No major complications occurred.
- Nearly all patients had contour irregularities after surgery, attributed to destruction of the fat above the platysma and of the platysma itself.
- Operative time was increased in all cases.
Terms
- Neck lift (cervicoplasty): surgery to tighten the skin, muscle and deeper tissue of the neck.
- Deep cervicoplasty: a neck lift that also treats structures under the platysma muscle, such as deep fat or glands.
- Platysma: the thin, flat muscle that covers the front of the neck.
- Fibrosis: scar tissue that forms inside tissue after injury or treatment.
- Chemolipolysis: injection of a chemical that dissolves fat.
- Cryolipolysis: fat reduction by controlled cooling.
- Tissue planes: natural layers between tissues that a surgeon separates during an operation.