THE AGING NECK - PowerPoint PPT Presentation

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the aging neck n.
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THE AGING NECK

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  1. THE AGING NECK Carl Schreiner, MD Byron Bailey, MD October 10,1997

  2. Introduction • Aesthetics • cervicomental angle • Anatomy • SMAS • platysma • skin attachments • vector forces • “sling effect” • ?depressor of lower lip

  3. CLASSIFICATION • Diagnosis • skin • muscle • fat • skeletal • Dedo classification

  4. PATIENT SELECTION • Expectations • Photography • Asses hyoid • Assymetries • Prior Bells palsy • Smoking

  5. SURGICAL OPTIONS • SMAS Rhytidectomy • Submental liposuction • Submentoplasty • Mentoplasty • Combined procedure


  6. RHYTIDECTOMY • Cornerstone operation for the neck • Class I and II • Flap elevation • SMAS plication vs imbrication • Deep plane and subperiosteal lifts

  7. SUBMENTAL LIPOSUCTION • Class III patients - “double chin” • Better than direct excision • Complications • submental deformities • platysmal banding • ? Beneficial alone

  8. SUBMENTOPLASTY • Class IV patients • Sharp supraplatysmal dissection • Platysma manipulation • reaproximation vs imbrication • Complications • marginal n. injury • masculinization of female neck • submandibular gland ptosis

  9. DIRECT SKIN EXCISION • “Turkey Gobbler” deformity • Submental scar • Males only • Address platysma separately • Z, A-T, T-Z closure

  10. COMPLICATIONS • Hematoma • Facial nerve injury • Great auricular nerve injury • Skin slough • Submandibular gland ptosis • Submental deformities • depression, pseudobanding, “cobra”deformity