Background
With an increased focus on the neck and chin due to selfies and social media, more consumers want to fix their “double chin” or “tech neck.” In the past, full correction of the neck typically required both an incision behind the chin and ears. The chin incision allows for removal of fat behind the chin and tightening of the neck muscles, while the incisions behind the ears provide access to elevate and re-drape the neck skin, as well as subsequent removal of excess skin. While the incision behind the chin is short, the incisions behind the ears are long, painful and potentially very visible, especially with short-cropped hair.
However, the demographic considering these neck contouring procedures – Millennials and Generation X – don’t want painful or visible incisions that require a long recovery. This demographic is seeking out either completely non-invasive or minimally invasive procedures. They want it all…long-lasting results with minimal intervention and downtime. So, to meet the demand of these changing expectations, surgeons must innovate.
Enter the SIMI® neck lift. The Single Incision Minimally Invasive neck lift contours the neck and avoids painful or unsightly post-auricular scars. Fewer incisions benefit both males and females, but the lack of postauricular scars are particularly beneficial for men, who typically have shorter hair. And although pain from postauricular incisions can vary between surgical technique and a patient’s pain threshold, clearly the absence of an incision will be less painful than the presence of an incision.
Operative technique
With the SIMI neck lift a single incision is made behind the chin. Instead of directly behind the chin, the incision is made within the junction of the jaw and neck, at the cervicomental angle. Even though this incision if further back, it is still hidden within the shadow of the neck. By placing the incision further back, there is greater access and visibility to the entire neck.
Through this one incision, three procedures can be performed: liposuction; the platysma muscle is tightened; and the neck skin is widely undermined to the sternocleidomastoid muscles. This wide undermining allows for the “misplaced” skin in the midline to be repositioned or redraped across the entire neck. With this repositioning and smoothing out of the neck, no excess skin needs to be removed via postauricular incisions, thus avoiding long, painful and visible incisions.
Conclusion
A case series including 20 patients was published in Plastic Reconstructive Surgery1. Only one complication, a hematoma occurred, for a complication rate of 5%, comparable to a traditional neck lift.
Placement of the incision within the cervicomental angle and wide undermining of the neck skin allows the SIMI neck lift to be aggressively used for many types of neck lift patients. Gone are the days when patients with an obtuse cervicomandibular angle must receive unsightly postauricular scars. In the appropriate candidates, the SIMI neck lift provides a minimally invasive option for patients previously only considered a candidate for a full neck lift, which may render the traditional mini neck lift obsolete.
Reference:
1. Kaplan, J.L. MD (May 2019).The Single Incision Minimally Invasive (SIMI) Neck Lift. Plastic Reconstructive Surgery. Retrieved from https://journals.lww.com/prsgo/Fulltext/2019/05000/The_Single_Incision_Minimally_Invasive__SIMI__Neck.2.aspx
About the Author:
Jonathan Kaplan, M.D.
Dr. Kaplan is a board certified plastic surgeon based in San Francisco, Calif. and founder/CEO of BuildMyBod Health, a price transparency-lead generation platform. His presentations and published works all strive for the same goal – using statistical analysis and measurable outcomes to produce actionable insights in the clinical, scientific and practice management arena.
