Minimally invasive neck contouring: counter-directional thread traction lift with syringe liposuction

Background Thread lifting alone often provides insufficient volumetric reduction in the neck, whereas liposuction may not adequately address skin laxity. A combined approach was therefore developed to remove fat while improving skin laxity. We evaluated a minimally invasive neck-contouring method that combines counter-directional thread traction lifting with syringe liposuction to improve the cervicomental angle (CMA) and redefine the mandibular border.Methods Fifty-one patients who underwent combined syringe liposuction and absorbable thread lifting (MINT Lift EASY) were retrospectively reviewed. The procedure included 30–40 mL of syringe liposuction per side. Bidirectional traction was achieved using two lateral threads anchored to the platysma-auricular ligament for superolateral lifting and one central thread to pull the skin and platysma centrally. Outcomes were assessed using CMA change, liposuction volume metrics, the Global Aesthetic Improvement Scale, ultrasound imaging, and complications.Results Overall, 51 patients were included (12 men and 39 women; mean age, 40 years). The CMA decreased by 14.94° at postoperative day 1, and by 6.58°, 10.17°, and 11.58° at 1, 3, and 12 months, respectively. Liposuction volume analysis showed an aspiration-to-tumescent volume ratio of 60.3%, a sedimented fat-to-tumescent volume ratio of 23.8%, and a sedimented fat-to-aspiration volume ratio of 40.1%. Ultrasonography confirmed anchoring of the thread barbs to the platysma muscle.Conclusions The combined technique was associated with consistent improvement in the CMA and submandibular border definition, with only minor complications. Similar to the traction vector used in classical platysmaplasty, this bidirectional thread-lifting technique, using superolateral and central vectors, may help contour the neckline.