Deep Neck with Glandular Preservation represents the evolution of cervical contour surgery, prioritizing natural results, safety, and optimized recovery. Created within the Modern Face philosophy, this approach, led by Dr. Robério Brandão, revolutionizes how we view neck rejuvenation.
In this complete guide, you will discover how to achieve a defined and elegant cervical contour, minimizing risks and recovery time, without the need to remove the submandibular gland.
What is Deep Neck? Unraveling the Concept
The term Deep Neck, or deep neck lift, refers to a set of surgical techniques aimed at improving cervical contour, acting on structures below the platysma muscle. This approach goes beyond simple superficial fat removal, seeking a structural and lasting result.
Modern Deep Neck: The Evolution
Modern Deep Neck, within the Modern Face philosophy, represents a significant advance over traditional techniques. It is characterized by:
- Submandibular gland preservation: Minimizes risks and complications.
- Focus on deep structures: Treats subplatysmal fat, digastric muscle, and cervical fascia.
- Natural results: Seeks an elegant and defined contour, without the artificial look.
- Optimized recovery: Allows a faster return to daily activities.
Why Preserve the Submandibular Gland? The Essence of Safety
The decision to preserve the submandibular gland is one of the pillars of the Modern Face philosophy. This choice, which may seem conservative at first glance, is based on a careful analysis of the risks and benefits of gland removal.
Risks of Gland Removal
Submandibular gland removal is a delicate procedure involving significant risks:
- Hemorrhage: The region is richly vascularized, and gland removal can lead to bleeding difficult to control.
- Nerve injury: The marginal mandibular nerve and other important nerve branches pass close to the gland, increasing injury risk.
- Salivary fistula: Gland removal can result in salivary fistulas, requiring prolonged treatment.
The Safe Alternative: Focus on Deep Structures
Instead of removing the gland, Modern Deep Neck focuses on treating structures that actually contribute to cervical contour:
- Subplatysmal fat: Careful removal of fat below the platysma helps define the neck.
- Digastric muscle: Reduction (shaving) of the digastric muscle contributes to a smoother and more elegant contour.
- Cervical fascia: Releasing the cervical fascia allows for better tissue repositioning.
The Glandular Loop: Refining Contour without Risks
In some cases, even with deep structure treatment, the submandibular gland may remain prominent. In these cases, Dr. Robério uses the glandular loop technique:
- A strategic suture that “hides” the gland without removing it.
- The loop repositions the gland, creating a smoother and more natural contour.
- The technique is minimally invasive and does not present the risks associated with gland removal.
Applied Anatomy: Unlocking Neck Secrets
To perform a Deep Neck safely and effectively, it is fundamental to know the region’s anatomy. Let’s explore the main structures involved:
The Platysma: The Superficial Layer
The platysma is a thin, wide muscle extending from the chest to the mandible. It plays an important role in facial expression and neck support.
- Platysmaplasty: Suturing the medial edges of the platysma helps define neck contour.
- Platysmotomy: Partial release of the platysma can be used to smooth platysmal bands and improve aesthetic result.
The Digastric Muscle: Sculpting Deep Contour
The digastric muscle, located below the platysma, has a fundamental role in neck contour.
- Digastric shaving: Reducing digastric muscle volume contributes to a more defined and elegant neck.
The Cervical Fascia: The Safety Limit
The deep cervical fascia is a layer of connective tissue involving deep neck structures.
- Fasciotomy: Releasing the cervical fascia allows better tissue repositioning and contributes to a more natural result.
Important: The cervical fascia represents the safety limit. Crossing this barrier can lead to injuries of important nerves and vessels.
The Marginal Mandibular Nerve: Essential Protection
The marginal mandibular nerve is a branch of the facial nerve controlling muscles responsible for lower lip expression. Injury to this nerve can lead to asymmetries and difficulties in speaking and eating.
- Preservation: It is fundamental to identify and protect the marginal nerve during surgery.
- Protection techniques: Avoiding deep dissections and excessive use of electrocautery near the nerve.
Indications: Who is Modern Deep Neck For?
Modern Deep Neck is indicated for patients presenting:
- Excess submental fat (double chin): Fat accumulation below the chin.
- Loss of mandibular contour definition: Lack of definition between neck and mandible.
- Platysmal bands: Presence of vertical cords in the neck.
- “Heavy” or “full” neck: General aspect of lack of definition and contour.
Pre-Operative Evaluation: Planning Success
A detailed pre-operative evaluation is essential to determine the best approach for each patient. This evaluation should include:
- Complete medical history: To identify conditions that may increase surgical risk.
- Detailed physical exam: To evaluate neck anatomy and identify structures needing treatment.
- Imaging tests (optional): In some cases, exams like ultrasound or MRI can be useful to evaluate deep fat and muscular anatomy.
The Surgical Technique: Step-by-Step to Perfect Contour
Let’s now detail the Modern Deep Neck surgical technique:
1. Incision
- Submental incision: Small incision below the chin, used to access deep neck structures.
- Cervical incision: Incision behind the ears, used to pull and fix the platysma.
2. Liposuction (Optional)
In some cases, gentle liposuction of superficial neck fat may be performed.
3. Platysma Treatment
- Platysmotomy: Release of inferior platysma insertions to allow its mobilization.
- Platysmaplasty: Suture of medial platysma edges to create muscular support for the neck.
- Lateral Traction (Crevassi): Traction and fixation of the lateral portion of the platysma on the sternocleidomastoid muscle (SCM) fascia to define mandibular contour.
4. Digastric Muscle Treatment
- Digastric muscle identification: Visualization of the digastric muscle after platysma dissection.
- Partial digastric muscle resection (shaving): Removal of a portion of the digastric muscle to reduce volume in the region.
5. Submandibular Gland Treatment (Glandular Loop)
- Submandibular gland identification: Visualization of the submandibular gland.
- Glandular loop creation: Passing a suture thread around the submandibular gland, without removing it, to reposition it and improve neck contour.
6. Closure
- Careful incision suture: Closure of incisions with techniques minimizing scar formation.
Recovery: What to Expect After Surgery
Recovery after Modern Deep Neck varies from patient to patient, but generally involves:
- Rest: Avoid strenuous activities in the first weeks.
- Compressive dressings: Use of dressings to control swelling and hematoma.
- Lymphatic drainage: Lymphatic drainage sessions to accelerate recovery.
- Medication: Painkillers and anti-inflammatories to control pain and swelling.
Risks and Complications: Knowledge is Safety
Like every surgery, Modern Deep Neck presents potential risks and complications:
- Hematoma: Blood accumulation under the skin.
- Seroma: Fluid accumulation under the skin.
- Infection: Rare, but possible.
- Nerve injury: Injury to the marginal mandibular nerve, which can lead to mouth asymmetry.
- Sensitivity changes: Numbness or tingling in the operated area.
Choosing an experienced surgeon and adhering to post-operative instructions are fundamental to minimizing these risks.
Results: Cervical Contour Transformation
Modern Deep Neck can provide notable results in defining cervical contour.
- More defined and elegant neck: Reduction of double chin and improvement of angle between neck and mandible.
- Complete facial rejuvenation: Improvement of harmony between neck and face.
- Increased self-confidence: Improvement of self-esteem and body image.
Choosing a Surgeon: Expertise and Trust
Choosing a qualified and experienced plastic surgeon is fundamental for Modern Deep Neck success.
- Check credentials: Ensure the surgeon is a member of the relevant plastic surgery society.
- Evaluate experience: Check the number of Deep Neck surgeries performed by the surgeon.
- Analyze portfolio: Ask to see before and after photos of patients operated by the surgeon.
- Talk to the surgeon: Ask all your questions and ensure you feel comfortable and confident with the professional.
Comparison: Techniques and Approaches
Understanding differences between available techniques helps in informed decision-making.
Overview of Approaches
| Aspect | Traditional Techniques | Modern Face |
|---|---|---|
| Surgical plane | Generally superficial | Deep (sub-SMAS) |
| Traction vector | Predominantly lateral | Vertical anatomically correct |
| Incision | Extensive, multiple areas | Minimal, strategically positioned |
| Recovery | 2-4 weeks | 7-14 days average |
| Durability | 5-7 years | 10-15 years |
| Naturalness | Risk of “stretched” look | Preserves natural expression |
Benefits of Modern Approach
The Modern Face technique offers specific benefits:
- More natural results: vertical vector respects facial anatomy
- Shorter recovery time: minimally invasive techniques accelerate healing
- Superior durability: work in deep plane offers more lasting support
- Less visible scars: strategic and smaller incisions
- Preservation of expressiveness: face remains natural and mobile
When Each Technique is Indicated
Technique choice depends on individual factors:
- Aging degree: more advanced cases may require more comprehensive approaches
- Areas of concern: midface, lower face, or neck have specific techniques
- Patient expectations: balance between desired result and acceptable recovery
- History of previous procedures: revisions require special planning
Conclusion
Modern Deep Neck is an innovative and effective technique for neck rejuvenation. By prioritizing safety, naturalness, and optimized recovery, this approach represents a significant advance in facial plastic surgery.
If you seek a defined and elegant cervical contour, talk to a qualified plastic surgeon and discover if Modern Deep Neck is the best option for you.
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⚠️ Disclaimer
This content is educational and represents the author’s technical opinion based on documented clinical experience. Surgical decisions should be individualized.
Author: Dr. Robério Brandão, CRM-CE 8596 Last update: January 2026