{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:27:51Z","timestamp":1779409671297,"version":"3.53.1"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Facial and cervical aging is a multilayered process influenced by skeletal support, soft-tissue volume and position, ligamentous integrity, and skin quality. Ancestry-associated anatomic variation may affect clinical presentation, but surgical planning must remain anatomy-based rather than race-defined. This review outlines contemporary strategies for management of the heavy neck in ethnically diverse patients.<\/jats:p>\n                  <jats:p>In many ethnic patients, neck aging is driven predominantly by big structural changes rather than early cutaneous laxity. Thicker dermis, heavier soft tissues, relative chin retrusion, and preserved dermal elasticity predispose to progressive cervicomental obtuseness. Patients presenting with obtuse cervicomental contours related to deep cervical structures benefit most from anatomy-directed intervention rather than superficial fat reduction alone.<\/jats:p>\n                  <jats:p>Management frequently includes submental deep neck contouring with selective reduction of subplatysmal fat, anterior digastric bellies, and submandibular glands, combined with platysmaplasty, with or without conservative subcutaneous fat removal. Optimal outcomes often require integration with facial rejuvenation, incorporating extended facelift techniques that emphasize comprehensive retaining-ligament release rather than traditional superficial musculoaponeurotic system lift procedures.<\/jats:p>\n                  <jats:p>Surgical strategy should be guided by individual anatomy rather than ethnoracial categorization. Anatomy-based, patient-centered planning enables natural, balanced, and durable cervicofacial outcomes while preserving patient-specific aesthetic identity.<\/jats:p>","DOI":"10.1055\/a-2866-3159","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:06:21Z","timestamp":1778022381000},"source":"Crossref","is-referenced-by-count":0,"title":["Management of the Heavy Neck in the Ethnic Patient"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7804-5002","authenticated-orcid":false,"given":"Ozcan","family":"Cakmak","sequence":"additional","affiliation":[{"name":"Facial Plastic Surgery, FACEISTANBUL, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Tarik","family":"Kavak","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Van Regional Training and Research Hospital, Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.fsc.2022.07.004","article-title":"Face and neck lift options in patients of ethnic descent","volume":"30","author":"E JD Whitehead","year":"2022","journal-title":"Facial Plast Surg Clin North Am"},{"key":"ref2","first-page":"874","article-title":"Hidden in plain sight\u2014reconsidering the use of race correction in clinical algorithms","author":"D A Vyas","year":"2020","journal-title":"Mass Medical Soc"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.scs.0000171847.58031.9e","article-title":"International anthropometric study of facial morphology in various ethnic groups\/races","volume":"16","author":"L G Farkas","year":"2005","journal-title":"J Craniofac Surg"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s00266-001-0033-7","article-title":"Proportionality in Asian and North American Caucasian faces using neoclassical facial canons as criteria","volume":"26","author":"T T Le","year":"2002","journal-title":"Aesthetic Plast Surg"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1001\/archfaci.6.2.78","article-title":"The average African American male face: an anthropometric analysis","volume":"6","author":"J P Porter","year":"2004","journal-title":"Arch Facial Plast Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1093\/aje\/154.4.291","article-title":"Commentary: considerations for use of racial\/ethnic classification in etiologic research","volume":"154","author":"J S Kaufman","year":"2001","journal-title":"Am J Epidemiol"},{"issue":"24","key":"ref7","doi-asserted-by":"crossref","first-page":"5273","DOI":"10.1007\/s00266-024-04266-w","article-title":"There is no universal standard of beauty","volume":"48","author":"R Singer","year":"2024","journal-title":"Aesthetic Plast Surg"},{"issue":"01","key":"ref8","first-page":"31","article-title":"Aging differences in ethnic skin","volume":"9","author":"N A Vashi","year":"2016","journal-title":"J Clin Aesthet Dermatol"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1097\/DSS.0000000000002237","article-title":"Racial and ethnic differences in self-assessed facial aging in women: results from a multinational study","volume":"45","author":"A F Alexis","year":"2019","journal-title":"Dermatol Surg"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1111\/jocd.15688","article-title":"Aesthetic considerations when treating patients of African descent: thriving in diversity international roundtable series","volume":"22","author":"S G Fabi","year":"2023","journal-title":"J Cosmet Dermatol"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1111\/jocd.15787","article-title":"Aesthetic considerations for treating the Asian patient: thriving in diversity international roundtable series","volume":"22","author":"S G Fabi","year":"2023","journal-title":"J Cosmet Dermatol"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1467-2494.2006.00302.x","article-title":"Ethnic skin types: are there differences in skin structure and function?","volume":"28","author":"A V Rawlings","year":"2006","journal-title":"Int J Cosmet Sci"},{"key":"ref13","volume-title":"The structure of black skin. 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