Overview
Open platysmaplasty gives direct access to neck structures but adds a scar, while closed techniques are less invasive but may correct less. The authors compared patient-reported FACE-Q scores for open and closed neck techniques, with and without liposuction. They searched MEDLINE, Embase, PubMed and the Cochrane Library through November 2024 and compared scores using weighted means and Welch's t-tests.
Findings
- 9 studies; 847 patients.
- With liposuction, neck satisfaction: open 81.5 vs closed 77.5 (P = .022).
- With liposuction, chin scores were comparable between open and closed (P = .268).
- Closed techniques without liposuction: chin 86.4, neck 86.6, the highest scores.
- These closed scores were significantly higher than open techniques with liposuction (P < .01).
- Level of evidence: 4.
What it means for a patient
- Patients who had a closed neck lift without liposuction reported the highest satisfaction.
- When liposuction was part of the plan, open platysmaplasty gave higher neck satisfaction than closed techniques.
- The authors state closed techniques suit appropriately selected patients and open techniques suit those needing more extensive correction.
- Limits: 9 studies, patient-reported scores only, and comparison of group averages rather than matched patients.
Why this paper matters
It pools FACE-Q scores to compare open and closed neck rejuvenation. It supports matching the neck technique to the patient rather than using open platysmaplasty for everyone.
Terms
- Platysmaplasty: surgery to tighten or reshape the platysma, the thin muscle sheet of the neck.
- Open technique: neck surgery that opens access to the platysma directly, adding a scar.
- Closed technique: less invasive neck surgery without that open access.
- Liposuction: removal of fat through a thin suction tube.
- FACE-Q: a standard questionnaire for patient-reported results of facial procedures; higher scores mean more satisfaction.
- Welch's t-test: a statistical test comparing two group averages.
- Meta-analysis: a method that pools results from several studies.