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Objectifying Aesthetic Outcomes Following Necklift Surgery - A Pilot Study
Leonard Knoedler, MD1, Raffaele Aguglia, MD
1, Tobias Niederegger, Bac
2, Thomas Schaschinger, BSc
2, Khalil Sherwani, MD
2, Jakob Fenske, DMD
3, Kevin Sadati, DO
4, Rainer Pooth, MD
5, Curtis Cetrulo, MD
1, Alexandre Lellouch, MD, PhD
1.
1Cedars Sinai, Los Angeles, CA, USA,
2University Hospital Regensburg, Regensburg, Germany,
3Charite University Hospital, Berlin, Germany,
4Private Practive, Newport Beach, CA, USA,
5ICA Aesthetic Navigation, Frankfurt am Main, Germany.
PURPOSE: Necklift surgery restores cervicomental contour and youthfulness, yet outcomes remain mostly assessed by subjective surgeon or patient impressions, subject to bias and variability. Objective, reproducible evaluation tools are needed. This pilot study combined CAARISMA® ARMM with Vectra® imaging to test an automated pipeline for quantitative necklift outcome assessment.
METHODS: A retrospective analysis of 10 female patients undergoing elective necklift at a single private practice was performed. Standardized pre- and postoperative images (3-month follow-up) were acquired with the Vectra® H2 system and analyzed using CAARISMA® ARMM. Outcome measures: Facial Youth Index (FYI), Facial Attractiveness Index (FAI), and Skin Quality Index (SQI). Subgroup analyses of SQI parameters and wrinkle scores were conducted.
RESULTS: Postoperative scores improved significantly: FYI increased from 40.8±1.0 to 42.1±1.6 (Δ 1.3±1.5; 2.1±1.8%; p=0.016), FAI from 73.5±15.8 to 83.3±8.8 (Δ 9.8±10.6; 12.3±13.3%; p=0.008), and SQI from 58.5±13.0 to 68.4±13.8 (Δ9.9±6.9; 14.3±8.9%; p=0.001). Variability was lowest for FYI (CV 2.5-3.8%) and highest for FAI (CV 21.5-10.6%). SQI showed the most consistent relative improvement (Δ% CV 62.3%). Subgroup analysis revealed the largest gains in fine relief (Δ17.1; 56.2%), rough relief (Δ9.5; 13.0%), and roughness (Δ9.3; 15.6%). Wrinkle scores improved, notably in crow’s feet (Δ9.4; 10.4%), infraorbital (Δ5.2; 6.6%), and marionette regions (Δ3.4; 4.0%).
CONCLUSION: Integrating CAARISMA® ARMM into the Vectra® workflow enables objective, reproducible necklift outcome evaluation while reducing variability. Despite the small cohort, results support its scalability for communication and evidence-based practice, warranting validation in larger studies.
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