Adjunctive Transverse Subcutaneous Cervical Suspension During Short-Scar Facelift: A Technical Note

Background: Achieving predictable improvement of the neck remains one of the main challenges of short-scar facelift surgery. Although lateral platysma plication improves cervical contour, selected patients may benefit from additional cervical support as an adjunct to cervical rejuvenation procedures. Objectives: To describe a simple adjunctive transverse cervical suspension maneuver that can be incorporated into limited-dissection facelift surgery to provide supplementary cervical support in selected patients and to report the author’s initial clinical experience with the maneuver. Methods: After limited cervical release and routine lateral platysma plication, 2 independent 2-0 polypropylene sutures are anchored to the mastoid fascia, 1 on each side, and passed through the previously released cervical plane using a blunt Reverdin needle, superficial to the platysma. Both sutures are exteriorized through a single midline puncture at the level of the hyoid bone, where the free ends are tied together and the knot is buried; the puncture is closed with a 5-0 polypropylene suture. Results: The maneuver adds approximately 5 minutes to the operative time and requires no additional formal surgical incision. It has been performed in 20 consecutive patients; 1 patient developed partial extrusion of a superficially placed midline knot, which was removed in the outpatient clinic without sequelae, and no other complications attributable to the suspension were observed. Conclusions: This maneuver is simple, reproducible, and easily incorporated into limited-dissection facelift surgery. It is intended to provide supplementary support to the cervical skin-subcutaneous flap in appropriately selected patients, although the present report describes technical feasibility rather than demonstrated clinical efficacy or long-term durability.