Rejuvenation of the aging neck: current principles, techniques, and newer modifications.

Aesthetic improvement of the neck and cervicomental angle remains one of the most challenging aspects of surgical facial rejuvenation. Individuals may become dissatisfied with the appearance of their neck because of changes in skin quality, submental fat, and muscle tone or anatomic position related to aging, weight gain, weight loss, sun damage, and other causes. To achieve the patient's desired result, surgeons use various techniques, either in isolation or in combination. Careful preoperative evaluation of the patient's anatomy dictates the most appropriate procedure, ranging from laser skin resurfacing to sub-superficial muscular aponeurotic system (sub-SMAS) rhytidectomy with an extended platysmaplasty. This article reviews the techniques that are available and the decision-making process in choosing the appropriate technique for the individual patient.