Redefining Neck Rejuvenation: The Novel Hyoid-to-Mastoid Crevasse Neo-Ligament and OnderKaak Angle in Deep Plane Neck Lift

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Neck rejuvenation has evolved from superficial skin tightening to deeper structural modifications targeting the platysma, submental and subplatysmal fat, and the submandibular gland (SMG). Significant controversy surrounds the surgical maneuvers necessary to achieve the ideal neck. Objectives The objective is to introduce the Hyoid-to-Mastoid Crevasse (HMC) neo-ligament for neck rejuvenation that elevates the SMG via a suture secured from the hyoid periosteum to the mastoid crevasse. Moreover, we introduce the OnderKaak (OK) angle, representing the region overlying the submandibular gland, best appreciated from the posterior oblique view, also known as the reverse ogee view. Methods Patients who underwent deep plane facelift and neck lift with HMC neo-ligament performed between January 2024 and October 2024 were included. Cervicomental (CMA), gonial (GA), and OK angle measurements were recorded pre and postoperatively. Patients were divided into two cohorts: without SMG resection ("no-SMG resection") and with SMG resection ("SMG resection"). Results A total of 25 patients were included. Fifteen patients (60%) underwent partial SMG resection, and 10 (40%) did not. Both groups demonstrated significant improvement in cervicomental, gonial, and OK angles (all P P > .05). Conclusions The HMC neo-ligament can be used to achieve improved neck aesthetics, thus offering a new

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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