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

Ulrich Eugen Ziegler; Ruth Schaefer; Adrien Daigeler; Philip Helge Zeplin

doi:doi:10.11648/j.js.20210902.13

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

Ulrich Eugen Ziegler, Ruth Schaefer, Adrien Daigeler, Philip Helge Zeplin

Published in Journal of Surgery (Volume 9, Issue 2)

Received: 2 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.

Published in	Journal of Surgery (Volume 9, Issue 2)
DOI	10.11648/j.js.20210902.13
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), 2021. Published by Science Publishing Group

Keywords

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

References

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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://article.sciencepublishinggroup.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
PY  - 2021
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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Author Information

Ulrich Eugen Ziegler

Praxis Dr. Ziegler, Stuttgart, Germany
Ruth Schaefer

Department of Hand, Plastic and Reconstructive Surgery, University of Tuebingen, Tuebingen, Germany
Adrien Daigeler

Department of Hand, Plastic and Reconstructive Surgery, University of Tuebingen, Tuebingen, Germany
Philip Helge Zeplin

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

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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

Copy | Download

@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://article.sciencepublishinggroup.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
PY  - 2021
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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