Patient-Reported Outcomes of Anterior Digastric Myectomy in Deep Plane Facelift and Neck Lift Surgery

<b>Background:</b> Aesthetic neck contouring is a key component to facial rejuvenation. <b>Objective:</b> To compare patient-reported symptoms after deep neck lift with versus without anterior digastric (AD) myectomy. <b>Methods:</b> 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. <b>Results:</b> 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%, <i>p</i> = 0.0015. Revision neck lift was lower with AD myectomy: 3.9% versus 9.2%, <i>p</i> = 0.027. <b>Conclusions:</b> AD myectomy does not increase functional complications and reduces neck tightness and revision surgery.