Patent RU-2741620-C1 (RU)
Title: Neck lifting method
Inventor: Vasilev Maksim Nikolaevich
IPC: A61B17/00
Filed: 2020-02-27
Granted: 2021-01-28
Abstract: FIELD: medicine. 
     SUBSTANCE: invention refers to medicine, namely to aesthetic, plastic and maxillofacial surgery in neck lifting. Liposuction of the neck is performed, skin incisions are made in 3 cm-deep chin fold around the ear lobes and in the behind-ear areas on the right and on the left. Skin flap is peeled in an area of an anterior region of the neck and a lower one-third of the face, within the following limits: at the bottom to the projection line on the skin of the cyst-shaped cartilage, at the top to line extending 2 cm above the lower jaw edge, medially to the lip-scapular fold, laterally to a projection of sternocleidomastoid muscles. Through the incision in the submental fold, vertical plication of the platysma is made along midline to 1 cm below the projection of the hyoid bone, subplatysmal fat is removed within boundaries - laterally to anterior abdominal digits of the digastric muscle, at the bottom to hyoid bone projection, at the top to chin protrusion. Further, platysma flaps are peeled laterally on the right and left by 3 cm. At level of 1 cm below the projection of the hyoid bone, dissected right and left platysma flaps are inclined in an oblique crosswise direction 3 cm laterally on each side. Then the left flap of platysma is turned out and to the posterior surface of the left flap of platysma is anchored with nodular threads, with tension, free edge of the right platysma, mesh triangle-shaped implant is laid on the front surface of the right platysma, the size matching the size of the submental triangle, base of the mesh triangular-shaped implant is oriented in the hyoid bone projection, the apex is oriented to the chin protrusion, the mesh implant is fixed to peripheral platy by interrupted sutures, then the free edge of the left platysmas flap is anchored with interrupted sutures above the mesh implant with tension towards the anterior surface of the right platysmal flap such that the mesh implant is completely covered by platysma. Thus, a strong hammock is formed in the submental area, consisting of right and left platysmae flaps, cross-linked, and mesh implant between them. Then a continuous dotted suture is applied from the non-absorbable suture, the first stitch is sutured from the middle of the platysmal duplication base and the mesh implant by 5 mm above the edge of the duplicating base, duplicate base, including mesh implant and platysmal plaques, are grasped in stitches, then with continuous dotted supporting suturing is performed with platysma in transverse direction along neck flexion line passing to post-BTE area, suturing a periosteal mastoid of left parotid region, suturing back, applying this dotted supporting suture at 5 mm below previous stitches, in medial direction to platysmogy duplication with mesh implant, duplication of platysma with mesh implant is sutured with continuous dotted suturing seizing duplicate base edge 5 mm below previously applied stitches, then continue to apply stitches of continuous dotted supporting suture platysma in transverse direction along neck bending line in direction to behind-eye area, the periosteum of the parotid region is sutured to the right, returned with a dotted supporting suture 5 mm above the superimposed stitches, in the direction medially to the platysmal duplication with the mesh implant. Base of the duplication of platysm with a mesh implant is sutured 5 mm above the edge of the base of the duplication, a superimposed continuous dotted suture is pulled and the knot is tied using the beginning and end of the suture. Thus, loop is formed from continuous dotted supporting seam with three anchor zones: in a forehead region on the left, in the BTE area on the right, in the zone of the base of the duplication of platysma with a triangular mesh implant. This loop from a continuous dotted supporting suture passes from the right and from the left in a projection of submandibular salivary glands on area of platysma. It is followed by spreading, tightening and excising excess of skin-fat flap in parotid region from both sides, intradermal suture is applied on incisions of parotid region and chin area. 
     EFFECT: method enables stabile elimination of all age-related changes in neck area, eliminated sagging of neck tissues with head inclination, and forms a clear cervical-chin angle. 
     1 cl, 1 ex, 20 dwg