Neck aesthetics have been a goal of our patients for years, however recent events have led to a more acute interest in how we appear in Zoom calls, Facetime, and social media. The flexed position of the neck while viewing digital devices accentuates fat malposition and excess neck skin. Conservative measures are refractory and non-surgical treatments such as Kybella and CoolSculpting are often at best insufficient and at worst can exacerbate the condition. Historically direct suctioning of fat was our only option short of an open necklift. However, the simple removal of the fat often did not correct the underlying submental skin malposition or provide any structural support for the neck contours. The introduction of energy based treatments to tighten the skin envelope helped but overuse of this technology resulted in stiff and leathery skin with poor compliance and suboptimal aesthetic results. The innovation of structural neck contouring by subdermal structural support with soft permanent sutures placed percutaneously is revolutionary.
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