Journal
Notes on the neck, for surgeons.
Short, referenced pieces on the decisions behind deep neck surgery: how to read a neck, where the danger zones are, what to do with the gland and how to adapt the platysma. Written around the programme of All About The Neck, Edition I.
Submandibular Gland Management in Deep Plane Neck Lift: What an 83-Patient Series Adds
Preserve, support or reduce? How the submandibular gland shapes the neck contour, and what a 2025 series of 83 LigaSure-assisted partial excisions reports.
7 min readPatient analysisReading the Neck: Fat, Muscle, Gland or Bone?
How to analyse the neck before surgery: superficial versus deep fullness, platysmal bands, the submandibular gland and the limits set by hyoid position.
7 min readPlatysmaPlatysma Adaptation After Deep Neck Contouring: Beyond Tightening
After deep fat, digastric or gland work, the platysma sits on a new foundation. Why release, redraping and reconstruction matter more than simple tightening.
6 min readSurgical anatomySurgical Anatomy of the Deep Neck: Layers, Landmarks and Danger Zones
Neck layers from skin to mylohyoid and the danger zones of deep neck contouring: facial nerve branches, facial vessels, the duct and the lingual nerve.
7 min readCourseNeck Lift Cadaver Course: What Hands-On Dissection Adds and What to Expect
Why cadaver dissection still matters in neck surgery training, and how a two day course on deep neck contouring and platysma reconstruction is structured.
6 min readFAQ
Frequently asked questions
Does every deep plane neck lift need submandibular gland excision?
No. Many necks have no meaningful gland contribution to the contour. The gland is assessed before surgery and again after deep fat contouring, and preservation, suture support or conservative partial reduction are chosen according to what is actually visible. Read: Submandibular Gland Management in Deep Plane Neck Lift: What an 83-Patient Series Adds
What is LigaSure and why was it used for gland excision?
LigaSure (Valleylab, Boulder, Colorado) is a bipolar energy-based instrument that permanently seals vessels and connective tissue. In the 2025 series it was used for partial gland excision to make the step technically easier and to reduce bleeding and hematoma risk. Read: Submandibular Gland Management in Deep Plane Neck Lift: What an 83-Patient Series Adds
How do you tell subcutaneous fat from subplatysmal fat?
Ask the patient to contract the platysma. Fat that can still be pinched above the contracted muscle is subcutaneous. Fullness that persists or becomes more apparent beneath the muscle suggests a deep contribution such as subplatysmal fat, digastric bulk or the submandibular gland. Read: Reading the Neck: Fat, Muscle, Gland or Bone?
Can a neck lift change hyoid position?
Soft tissue surgery does not move the hyoid. A low or anterior hyoid limits how sharp the cervicomental angle can become, which is why skeletal support is assessed before surgery and expectations are set accordingly. Read: Reading the Neck: Fat, Muscle, Gland or Bone?
Is platysmaplasty the same as a neck lift?
No. Platysmaplasty addresses the platysma muscle itself, for example by approximating its medial borders. A neck lift may combine platysma work with skin redraping and, when indicated, deep neck contouring of subplatysmal fat, digastric muscles or the submandibular gland. Read: Platysma Adaptation After Deep Neck Contouring: Beyond Tightening
Why does the platysma need to be adapted after deep neck contouring?
Removing deep volume changes the foundation the muscle drapes over. Adapting it through release, redraping and reconstruction lets the muscle follow the new contour and keeps the deep work hidden, rather than relying on tension alone. Read: Platysma Adaptation After Deep Neck Contouring: Beyond Tightening
Where is the marginal mandibular nerve at risk in a neck lift?
Near the mandibular border, deep to the platysma, and over the submandibular gland. In some patients it runs below the mandibular border, which is why subplatysmal dissection in this region is done with the nerve's course in mind. Read: Surgical Anatomy of the Deep Neck: Layers, Landmarks and Danger Zones
Does lower lip weakness after neck surgery always mean marginal mandibular nerve injury?
No. The cervical branch of the facial nerve supplies the platysma, and its injury can also cause lower lip asymmetry. Distinguishing the two is part of the danger-zone teaching. Read: Surgical Anatomy of the Deep Neck: Layers, Landmarks and Danger Zones
Who can apply to the All About The Neck cadaver course?
Board certified or board eligible plastic, reconstructive and aesthetic surgeons who already operate on the face and neck. The hosts review every application individually. Read: Neck Lift Cadaver Course: What Hands-On Dissection Adds and What to Expect
How many surgeons attend?
Edition I is limited to 10 surgeons, and every participant works at the table with both hosts. Read: Neck Lift Cadaver Course: What Hands-On Dissection Adds and What to Expect