Innovations in Rhytidoplasty: 480 Cases Validating the Efficacy of the Inner Hemostatic Net.

Abstract

Cervicofacial rejuvenation procedures often face challenges related to soft tissue repositioning, dead space management, and long-term contour stability. The internal hemostatic net (IHN) technique offers a systematic approach to deep fixation that improves surgical outcomes and reduces complications such as hematomas or tissue displacement. The authors of this study aim to describe a reproducible, layered suture technique for cervicofacial lifting that addresses deep neck contouring and flap stabilization through a combined submental and lateral approach, while minimizing the risk of postoperative complications. A prospective evaluation was conducted on patients undergoing cervicofacial lifting with IHN application. The technique involves 3 phases: submental quilting and fixation sutures after deep neck sculpting; lateral progressive tension and superficial musculoaponeurotic system-platysma anchoring sutures; and superficial quilting for flap adherence. A progressive reduction in suture caliber is applied according to tissue thickness. A double incision approach (submental and lateral) ensures controlled access and uniform distribution of vectors. The technique was applied in over 100 patients with consistent aesthetic improvements and no major complications. The elimination of dead space through deep-layer quilting and progressive tension sutures reduced hematoma rates and improved long-term contour definition. Minor complications were self-limiting and managed conservatively. The standardized sequence improved intraoperative control and postoperative predictability. The IHN technique provides a reliable, anatomically guided method for cervicofacial rejuvenation. By addressing the neck, face, and submental regions in a structured sequence, this approach enhances surgical precision, flap stability, and patient outcomes-offering a valuable contribution to aesthetic surgery literature.