Imbrication of Anterior Digastric with Advancement of the Posterior Digastric and Its Implications in Neck Aesthetics

Background: To describe a novel technique to modify the proportional length of the anterior-to-posterior digastric muscles to improve neck aesthetics. Objective: To provide an objective measure to quantify neck rejuvenation and a novel technique to adjust the digastric ratio. Design: We retrospectively compared 52 patients who had neck rejuvenation with or without digastric manipulation. Preoperative and postoperative images were analyzed and compared with computer software using a novel analysis technique to measure the digastric ratio and neck height. Distances between the menton, cervical point (CP), and gonion were measured. Results: The anterior-to-posterior digastric ratio improved an average of 26.5% (p < 0.01) in the new technique group, 15.9% in the control group. Distance of the CP to the inferior edge of the mandible decreased an average of 13.9% using the new technique. Conclusion: The ratio of anterior-to-posterior digastric muscle appears to improve as well as the neck height with manipulation of the digastric muscles.