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Original Investigation
Jan/Feb 2019

Analysis of Cervical Angle in the Submental Muscular Medialization and Suspension Procedure

Author Affiliations
  • 1Division of Facial Plastic Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Tennessee, Germantown
  • 2Private Practice, Flemington, New Jersey
  • 3Division of Facial Plastic Surgery, Department of Otolaryngology–Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
  • 4Department of Otolaryngology–Head and Neck Surgery, University of Tennessee, Memphis
  • 5The Langsdon Clinic, Germantown, Tennessee
JAMA Facial Plast Surg. 2019;21(1):56-60. doi:10.1001/jamafacial.2018.1097
Key Points

Question  Does the submental muscular medialization and suspension procedure produce greater improvement of the cervical angle in select patients vs traditional rhytidectomy techniques?

Findings  In this cohort study of 141 patients undergoing rhytidectomy, analysis of the change in cervical point position after submental muscular medialization and suspension revealed a statistically significant 2-cm increase in point depth.

Meaning  In select patients with obtuse cervicofacial angle and large submental fat pads, the submental muscular medialization and suspension technique appears to be an effective option to improve cervical point depth and cervicofacial angle.

Abstract

Importance  The submental muscular medialization and suspension (SMMS) procedure is an option for addressing an obtuse cervical angle in select patients vs the use of traditional rhytidectomy techniques.

Objective  To compare the change in position of the cervical point between groups undergoing SMMS vs the traditional rhytidectomy technique.

Design, Setting, and Participants  A retrospective review was performed of 141 patients undergoing rhytidectomy in an accredited private surgery center between January 1, 2013, and December 31, 2014, comparing cervical point depth between patients undergoing SMMS vs those undergoing traditional rhytidectomy with platysma plication. Statistical analysis was performed from November 11, 2017, to January 5, 2018.

Interventions  Patients underwent either SMMS or traditional rhytidectomy with platysma plication.

Main Outcomes and Measures  The primary end point was change in the cervical point distance between preoperative and postoperative standardized profile photos.

Results  A total of 141 patients were included in the analysis. A cohort of 46 patients (43 women and 3 men; mean age, 63.5 years [range, 49.0-79.0 years]) underwent neck contouring with the SMMS technique and a cohort of 95 patients (90 women and 5 men; mean age, 61.0 years [range, 48.0-73.0 years]) underwent traditional rhytidectomy with platysmaplasty. The cervical point distance of the SMMS cohort had a mean (SD) postoperative increase of 2.0 (1.05) cm (95% CI, 1.73-2.28; P < .001) compared with 0.78 (0.82) cm in the traditional rhytidectomy cohort (95% CI, 0.54-1.02; P < .001).

Conclusions and Relevance  The results of this study suggest that submental muscular medialization and suspension appears to be an effective option to address the obtuse neck in select patients.

Level of Evidence  3.

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