Abstract
Background:
Aesthetic neck contouring is a key component to facial rejuvenation.
Objective:
To compare patient-reported symptoms after deep neck lift with versus without anterior digastric (AD) myectomy.
Methods:
Retrospective cohort of patients undergoing neck lift (July 2020–December 2024) grouped by AD myectomy status. Primary outcomes were dysphagia, dysarthria, throat pain, and neck tightness lasting >1 month. Secondary outcomes included hematoma, seroma, scar revision, skin breakdown, and revision neck lift.
Results:
Of 452 patients with >3 months’ follow-up, 142 had no AD myectomy, and 310 had AD myectomy. Median age was 59 (53–65) versus 60 (54–64) years; 92% were female (89% vs. 94%). Median follow-up was 9.60 (4.53–16.69) versus 9.39 (5.78–13.35) months. Combination procedures were performed in 72% (59% vs. 78%), and submandibular gland reduction in 30.5% (0% vs. 44.5%). Primary complaints occurred in 9.9% (95% CI: 6.0–15.9) versus 10.0% (95% CI: 7.1–13.8) with no significant differences in dysphagia, dysarthria, or throat pain. Neck tightness was lower with AD myectomy: 4.8% versus 13.4%, p = 0.0015. Revision neck lift was lower with AD myectomy: 3.9% versus 9.2%, p = 0.027.
Conclusions:
AD myectomy does not increase functional complications and reduces neck tightness and revision surgery.
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