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Defining Clinically Relevant Fat Compartments in the Neck: A Cadaver Study

Larson, Jeffrey D Ozturk, Cemile N Zins, James E
Cleveland Clinic Foundation
2012-02-14

Presenter: Larson, Jeffrey

Affidavit:
All the work is original work.

Director Name: Bernard, Steve

Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

How does this presentation meet the established conference educational objectives?
Conference participants will be able to demonstrate knowledge of current concepts in aesthetic surgery of the neck, particularly addressing the composite anatomy of the neck and the impact it has on influencing surgical options.

How will your presentation be used by practicing physicians in the audience?
Practicing physicians will be able to correlate the anatomy described with their own surgical approaches to this technically challenging aspect of aesthetic surgery.

Background: Cervicoplasty is a key portion of aesthetic surgery of the face and neck. While the literature is replete with accounts of surgical options for this region, a thorough description of the fat content of this area has not been described. This study seeks to describe the compartments of fat in the neck with particular attention to those areas relevant to surgical management.

Methods: Fresh cadaver heads were obtained and the skin was removed. Each compartment of fat was weighed along with the submandibular gland, which was also measured and weighed. Superficial fat was found between the skin and the platysma muscle. This was further compartmentalized into suprahyoid and infrahyoid fat. The intermediate fat was found deep to the platysma and between the medial edges of the platysma in the midline. This fat was typically in an hour-glass shape and also fell into suprahyoid and infrahyoid compartments. The deep fat was deep to the anterior digastric muscles and submandibular gland, and adherent to the strap muscles.

Results: In one specimen, the superficial fat represented 53% of the fat in the neck, the intermediate fat represented 35%, and the submandibular gland represented 12%. The deep fat was scant, representing less than 1% of the fat in the neck.

Conclusion: This anatomic description provides a comprehensive view of fat in the neck, and should serve as an additional guide as we approach this important and challenging area in surgical rejuvenation.

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