A Systematic Review and Meta-Analysis of the Role of Open Platysmaplasty in Face and Neck Lift Surgery: Comparative Outcomes of Closed vs Open Neck Rejuvenation With Liposuction Using FACE-Q Scales

Abstract Background Facial and neck rejuvenation techniques have evolved significantly, aiming to achieve optimal patient satisfaction with minimal invasiveness. Open platysmaplasty techniques allow direct access to anatomical structures but involve additional scarring, whereas closed techniques are less invasive but might provide limited correction. There remains uncertainty regarding patient-reported outcomes between these approaches. Objectives This systematic review and meta-analysis assessed patient-reported outcomes (FACE-Q Aesthetic Module scores) comparing open versus closed neck rejuvenation techniques, with and without liposuction. Methods A systematic review was performed following PRISMA 2020 guidelines, searching databases (MEDLINE (Ovid), Embase (Ovid), PubMed, Cochrane Library) from inception to November 2024. Studies comparing open and closed neck lift techniques and reporting FACE-Q scores were included. Data were analyzed using weighted means, pooled standard deviations, and Welch’s t-tests to compare satisfaction scores. Results Nine studies with 847 patients were analyzed. When liposuction was employed, open techniques significantly improved neck aesthetic satisfaction (mean FACE-Q = 81.5) compared to closed techniques (mean FACE-Q = 77.5, p = 0.022), though chin scores were comparable (p = 0.268). Closed techniques without liposuction yielded the highest satisfaction scores for both chin (mean FACE-Q = 86.4) and neck (mean FACE-Q = 86.6), significantly exceeding open techniques with liposuction (p < 0.01). Conclusions Closed neck rejuvenation techniques without liposuction showed highest patient-reported outcomes for appropriately selected patients, emphasizing the importance of individualized surgical planning. Open techniques retain significant value for patients requiring more extensive anatomical correction.