Journal of Surgery

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Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm

Received: 02 March 2021    Accepted: 13 March 2021    Published: 22 March 2021
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Abstract

The neck is an often-neglected part of body lift procedures after massive weight loss. The objective of this study was to classify massive weight loss patients undergoing direct neck lift procedures and provide a standardized treatment algorithm. A retrospective review of all neck lift procedures performed between January of 2012 and December of 2019 was conducted. Patients were classified as follows: Grade I, no skin excess with remaining preplatysmal fat and no platysmal laxity; Grade IIa, moderate submental skin excess with subplatysmal fat deposits and platysmal laxity; Grade IIb, moderate anterior neck skin excess with no fat deposits and platysmal laxity; Grade III, considerable anterior skin excess with no or limited fat deposits and platysmal laxity and bands. Grade I patients had Liposuction, Grade IIa patients Submental Neck Lift with anterior fat excision and central platysmaplasty, Grade IIb Submental Neck Lift with central platysmaplasty, and Grade III patients Median Z-Plasty with fat excision (if needed) and central platysmal resection and tightening. Thirty-one patients were included for analysis. One underwent liposuction, twenty-five a Submental Neck Lift and five a Median Z-Plasty. Concomitant surgery was carried out in all cases. A recurrent skin laxity occurred in 2 (11.8%) patients, so in local anesthesia an operative revision was required. A standardized algorithmic approach for neck lift in massive weight loss patients may optimize the result without increasing the complication rate. Direct neck lift procedures prove to be reliable techniques with rare complication rates that can be performed together with other postbariatric procedures.

DOI 10.11648/j.js.20210902.13
Published in Journal of Surgery (Volume 9, Issue 2, April 2021)
Page(s) 58-62
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Massive Weigh Loss, Body Contouring, Neck Lift, Z-plasty, Submental

References
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Author Information
  • Praxis Dr. Ziegler, Stuttgart, Germany

  • Department of Hand, Plastic and Reconstructive Surgery, University of Tuebingen, Tuebingen, Germany

  • Department of Hand, Plastic and Reconstructive Surgery, University of Tuebingen, Tuebingen, Germany

  • Ludwigsburg Institute of Plastic Surgery, Schlosspark Klinik Ludwigsburg, Ludwigsburg, Germany

Cite This Article
  • APA Style

    Ulrich Eugen Ziegler, Ruth Schaefer, Adrien Daigeler, Philip Helge Zeplin. (2021). Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm. Journal of Surgery, 9(2), 58-62. https://doi.org/10.11648/j.js.20210902.13

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    ACS Style

    Ulrich Eugen Ziegler; Ruth Schaefer; Adrien Daigeler; Philip Helge Zeplin. Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm. J. Surg. 2021, 9(2), 58-62. doi: 10.11648/j.js.20210902.13

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    AMA Style

    Ulrich Eugen Ziegler, Ruth Schaefer, Adrien Daigeler, Philip Helge Zeplin. Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm. J Surg. 2021;9(2):58-62. doi: 10.11648/j.js.20210902.13

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  • @article{10.11648/j.js.20210902.13,
      author = {Ulrich Eugen Ziegler and Ruth Schaefer and Adrien Daigeler and Philip Helge Zeplin},
      title = {Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm},
      journal = {Journal of Surgery},
      volume = {9},
      number = {2},
      pages = {58-62},
      doi = {10.11648/j.js.20210902.13},
      url = {https://doi.org/10.11648/j.js.20210902.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20210902.13},
      abstract = {The neck is an often-neglected part of body lift procedures after massive weight loss. The objective of this study was to classify massive weight loss patients undergoing direct neck lift procedures and provide a standardized treatment algorithm. A retrospective review of all neck lift procedures performed between January of 2012 and December of 2019 was conducted. Patients were classified as follows: Grade I, no skin excess with remaining preplatysmal fat and no platysmal laxity; Grade IIa, moderate submental skin excess with subplatysmal fat deposits and platysmal laxity; Grade IIb, moderate anterior neck skin excess with no fat deposits and platysmal laxity; Grade III, considerable anterior skin excess with no or limited fat deposits and platysmal laxity and bands. Grade I patients had Liposuction, Grade IIa patients Submental Neck Lift with anterior fat excision and central platysmaplasty, Grade IIb Submental Neck Lift with central platysmaplasty, and Grade III patients Median Z-Plasty with fat excision (if needed) and central platysmal resection and tightening. Thirty-one patients were included for analysis. One underwent liposuction, twenty-five a Submental Neck Lift and five a Median Z-Plasty. Concomitant surgery was carried out in all cases. A recurrent skin laxity occurred in 2 (11.8%) patients, so in local anesthesia an operative revision was required. A standardized algorithmic approach for neck lift in massive weight loss patients may optimize the result without increasing the complication rate. Direct neck lift procedures prove to be reliable techniques with rare complication rates that can be performed together with other postbariatric procedures.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm
    AU  - Ulrich Eugen Ziegler
    AU  - Ruth Schaefer
    AU  - Adrien Daigeler
    AU  - Philip Helge Zeplin
    Y1  - 2021/03/22
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    N1  - https://doi.org/10.11648/j.js.20210902.13
    DO  - 10.11648/j.js.20210902.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 58
    EP  - 62
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210902.13
    AB  - The neck is an often-neglected part of body lift procedures after massive weight loss. The objective of this study was to classify massive weight loss patients undergoing direct neck lift procedures and provide a standardized treatment algorithm. A retrospective review of all neck lift procedures performed between January of 2012 and December of 2019 was conducted. Patients were classified as follows: Grade I, no skin excess with remaining preplatysmal fat and no platysmal laxity; Grade IIa, moderate submental skin excess with subplatysmal fat deposits and platysmal laxity; Grade IIb, moderate anterior neck skin excess with no fat deposits and platysmal laxity; Grade III, considerable anterior skin excess with no or limited fat deposits and platysmal laxity and bands. Grade I patients had Liposuction, Grade IIa patients Submental Neck Lift with anterior fat excision and central platysmaplasty, Grade IIb Submental Neck Lift with central platysmaplasty, and Grade III patients Median Z-Plasty with fat excision (if needed) and central platysmal resection and tightening. Thirty-one patients were included for analysis. One underwent liposuction, twenty-five a Submental Neck Lift and five a Median Z-Plasty. Concomitant surgery was carried out in all cases. A recurrent skin laxity occurred in 2 (11.8%) patients, so in local anesthesia an operative revision was required. A standardized algorithmic approach for neck lift in massive weight loss patients may optimize the result without increasing the complication rate. Direct neck lift procedures prove to be reliable techniques with rare complication rates that can be performed together with other postbariatric procedures.
    VL  - 9
    IS  - 2
    ER  - 

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