ABSTRACT
Volume assessment and modification is an integral part of neck lifts. Volume reduction is almost always a component of neck lifts in contrast to other areas of facial rejuvenation that commonly involve volume enhancement. A critical factor in achieving good results is preoperative assessment of volume in the three planes of the neck (superficial, intermediate, and deep) and the proper intraoperative techniques necessary to modify volume in each of these planes. These areas of possible volume modification include subcutaneous fat, fat between the platysma muscles, platysma muscles, subplatysmal fat, digastric muscles, and submandibular glands. We believe that the most common error in neck recontouring is overreduction of volume in the superficial (subcutaneous) plane in an attempt to improve or disguise volume problems in the intermediate or deep planes. The hesitancy of some surgeons to operate in the deeper layers of the neck may lead to suboptimal results.
