Dual-plane Deep Reduction Neck Lift for Cervical Lengthening in Short-neck Patients

BACKGROUND: Short-neck morphology remains a challenging problem in cervicofacial rejuvenation because conventional neck contouring techniques do not consistently improve neck length perception. OBJECTIVES: To evaluate a dual-plane deep reduction neck lift combining complete platysma transection and vector-controlled platysma repositioning for improvement of cervical contour and neck length perception in short-neck patients. METHODS: A retrospective cohort study included 167 consecutive patients who underwent deep-plane facelift combined with dual-plane deep reduction neck lift between May 2023 and June 2024. Ninety-five patients met the Auersvald criterion for short neck (neck-clavicle distance ≤24% of vertex-clavicle height) and were analyzed. The procedure combined deep neck reduction, hyoid fasciotomy, complete platysma transection, and differential repositioning of the cranial and caudal platysma segments. Outcomes included cervicomental angle, postoperative-to-preoperative anterior neck length ratio (PANL), FACE-Q assessment, blinded surgeon evaluation, and complications. RESULTS: The mean PANL ratio was 2.49 ± 0.11, demonstrating a significant increase in apparent cervical length (p < 0.001). All patients showed improvement in cervical contour. FACE-Q demonstrated high satisfaction, with 94.7% of patients reporting being very satisfied. Blinded evaluators reported a mean perceived age reduction of 16 years. Complications were limited to transient neuropraxia (4.3%) and sialoma (3.1%), with no permanent sequelae. CONCLUSIONS: Dual-plane deep reduction neck lift with vector-controlled platysma repositioning provides consistent improvement in cervical contour and neck length perception in selected short-neck patients, with high patient satisfaction and a favorable safety profile.