3D Neck Lift: A Dynamic Approach to Submental Anatomy.

[BACKGROUND] Traditional neck rejuvenation-liposuction, platysmaplasty, and skin redraping-overlooks intrinsic mandibular-cervical asymmetry,digastric insertions, platysmal discontinuity, submandibular gland descent, and age-related hyoid retrodisplacement. These influence submental contour and require a tridimensional, anatomy-based correction.

[METHODS] A retrospective study of 177 patients (99 women, 78 men; mean age 59 y, range 26-78 y) undergoing isolated neck rejuvenation (2003-2024) assessed outcomes of the 3D neck lift, which has been used since 2018 in Knize stage II-III and stage IV cases. The technique combines a triangular platysma myectomy forming a stabilizing neo-floor, partial digastric resection, and subplatysmal fat control, with platelet-rich plasma (PRP) (stages III-IV) or bipolar radiofrequency (stage IV). Results were evaluated by complications, morphology, and satisfaction.

[RESULTS] Mandibular asymmetry (broad on the left side) was present in 92% of patients. Stage distribution was: I, 28%; II, 35%; III, 21%; and IV, 16%. Chin implants were added in 10%, PRP in 31%, and radiofrequency in 6%. Complications were minimal, consisting of 2 transient marginal mandibular pareses (<6 wk) and 10 seromas, only 3 of which occurred since 2020; all resolved after a single aspiration. Excellent or good cervicomental angle definition was achieved in 98% of cases, with 96% of patients satisfied or very satisfied.

[CONCLUSIONS] The 3D neck lift offers a personalized, single-incision solution to submental rejuvenation, integrating natural asymmetry, triangular platysma resection, and fibrotic stabilization to restore a stable cervicomental angle with low morbidity. Adjuncts such as PRP or radiofrequency enhance advanced cases but are nonessential. This method provides a reliable, scar-sparing alternative for isolated neck rejuvenation.