Technical Structure
The 4 Pillars of Deep Neck
Each pillar is essential. Together, they transform the heavy neck into defined contour.
"Treating only skin and platysma is trimming the grass. Deep Neck is renovating the entire garden."
Floor Cleaning
Deep Fat
Interplatysmal and subplatysmal fat removal under direct vision.
- → Open platysma at midline
- → Remove fat with electrocautery under vision
- → Clean from hyoid upward
- → Preserve fat below hyoid
Metaphor
"Empty the pillow before tightening the pillowcase"
The Turning Point
Digastric Shaving
Selective reduction of hypertrophied anterior belly — the true villain.
- → Identify anterior belly
- → Resect 50-60% of volume
- → Transform from cylindrical to flat
- → NEVER plicate the tendon
Metaphor
"Prune the thick root from the garden"
Mandatory in 100%
Pre-hyoid Fasciotomy
Horizontal section of deep cervical fascia just above hyoid.
- → Horizontal incision above hyoid
- → Releases hyoid 'anchoring'
- → Increases mento-hyoid distance
- → Creates negative neck
Metaphor
"Release the brake holding the neck"
Final Architecture
Platysmorraphy + Crevassi
Medial platysma suture and lateral fixation to SCM fascia.
- → Platysmorraphy from mandible to hyoid
- → Moderate tension
- → Crevassi on SCM fascia
- → Defines mandibular angle
Metaphor
"Reinforce the structure"
"Pre-hyoid fasciotomy is mandatory in 100% of Deep Neck surgeries."