{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T15:40:09Z","timestamp":1724600409759},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>With increasing global trends in aesthetic surgery, the facial plastic surgeon will undoubtedly encounter a variety of patient types including those with more unfavorable underlying anatomy. The \u201cdifficult\u201d neck represents a cohort of individuals that exhibit both anatomical and patient-related factors that may limit overall surgical improvement. Anatomical issues that contribute to the difficult neck include excessive fat (\u201cheavy\u201d neck), ptosis of deep structures, obtuse cervicomental angle, and abnormalities of the underlying skeletal framework, such as a low set hyoid and inadequate chin projection. It is important that these factors are recognized and highlighted preoperatively, and that surgery is tailored appropriately to the individual. Although satisfactory results can be achieved, these may be ultimately limited, and it is important that patients understand this. We will present a review of current thinking alongside our own practice in the identification and management of these \u201cdifficult neck\u201d patients.<\/jats:p>","DOI":"10.1055\/s-0041-1725109","type":"journal-article","created":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T23:30:56Z","timestamp":1615073456000},"page":"168-175","source":"Crossref","is-referenced-by-count":0,"title":["The Difficult Neck Patient\u2014Practical Management: A Personal Approach"],"prefix":"10.1055","volume":"37","author":[{"given":"Kristian Haynes","family":"Hutson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Lewisham and Greenwich NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alwyn Ray","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Lewisham and Greenwich NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,6]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1097\/00006534-198012000-00003","article-title":"Visual criteria for success in restoring the youthful neck","volume":"66","author":"R Ellenbogen","year":"1980","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1055\/s-0030-1270423","article-title":"The McCollough facial rejuvenation system: a condition-specific classification algorithm","volume":"27","author":"E G McCollough","year":"2011","journal-title":"Facial Plast Surg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.cps.2008.06.003","article-title":"Lateral SMASectomy, plication and short scar facelifts: indications and techniques","volume":"35","author":"D C Baker","year":"2008","journal-title":"Clin Plast Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1288\/00005537-198011000-00020","article-title":"\u201cHow I do it\u201d\u2014plastic surgery. 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