Back to 2024 Abstracts
Minimally Invasive Necklift with the Mastoid Sling
Brannon Claytor
2, Lauren S. Lowe
*11Columbia University Vagelos College of Physicians and Surgeons, New York, NY; 2Main Line Health, Bryn Mawr, PA
While the definitive solution for aging and lipodystrophy is an open neck platysmaplasty, many patients are seeking a less invasive option with a faster recovery time. Modifications to existing approaches with liposuction, thermal heat energy and a suspension permanent suture lift can achieve dramatic results for the selected patient.
Patients are evaluated for cervicomental adipose content and elasticity of skin tissue. Those deemed appropriate are screened for tumescent local anesthesia procedure in our QUADA Class A facility. Local anesthetic is injected at planned incisions in the post auricular region. Following infusion with tumescent fluid, submental fat is liposuctioned with power-assisted liposuction through incisions just below the ear lobule. Laser thermal heating is performed through percutaneous technique into the subdermis and fat layers. The deployment of 4-0 Ethibond suture is started at the neck midline superior to the hyoid bone. The suture is threaded deep under the dermis to create a tunnel around the mastoid fascia in the retro auricular region. The suture is passed under the mastoid tunnel, through the skin and back, now securely anchored around the mastoid fascia and creating a sling to tighten against. The process is repeated on the contralateral side. A 4-0 Monocryl suture is placed in the subdermal layer just below the epidermis and through the mastoid sling. The Ethibond, then Monocryl suture is tied tightly. The patient is placed in a head wrap. No drains are used.
64 patients underwent the procedure. The average age and BMI was 49.1 and 26, respectively. 61 were female, 3 were males. Minimal complications occurred, including infection cleared with oral antibiotics and removal of sutures for skin puckering. There were no nerve injuries, seromas, or skin necrosis.
Although the open platysmaplasty remains the definitive treatment for neck aesthetics, the trifecta of liposuction, thermal energy and permanent suture suspension anchored on the mastoid sling may fill the void for aesthetic cervicomental and gonial angles results.
Back to 2024 Abstracts
