The neck is often the first place to show signs of aging in many men and women, and is an area of concern for many.  The aging neck can be defined by the amounts of excess skin, fat, and muscle, though evaluation of any particular patient’s neck must be done in the context of the entire face. As every neck has a different configuration, each must be treated with an individualized approach to address the underlying anatomy, which may consist of fat removal, skin removal, muscle tightening, or injectables. Surgery to address the aging neck (neck lift and submentoplasty) is often combined with facelift procedures for an optimum “balanced” result. There is no “one size fits all” approach to sculpt the neck and improve the contour, and Dr. Kundaria’s philosophy is to provide the patient with the information and options so that they can make the most educated decision as to how to proceed treating their neck.

Who is a Neck Lift Candidate?

Neck lift candidates can range from people with a complaint about extra skin in their “double chin” to others that have vertical neck bands.  Patients that have only extra fat but tight skin may only need chin liposuction.  However, anyone with complaints about loose skin or muscle bands in the neck will likely benefit more from surgery.

How is a Neck Lift Performed?

A neck lift is performed by an incision that goes from under the ear to the hairline, and then continues down the hairline.  If there is a lot of skin that is to be removed, then the incision may need to extend farther down the hairline as well as in front of the ear.  After the skin incision is done, the skin is undermined, that is, it is separated from the deep muscle of the neck, the platysma muscle.  Once the skin has been undermined, the muscle has to be addressed.  It is often pulled laterally, or outward, and secured in this position to pull the neck bands apart.  Sometimes, a separate incision has to be made under the chin so that these muscles can be stitched together in a “corset-type” closure in the middle, where they meet.  The procedure is repeated for the other side, and once the muscle has been tightened, the redundant skin is removed and stitched closed.

Where is a Neck Lift Performed?

At Nuance Facial Plastics, neck lift surgeries are commonly done under local anesthesia in the office.  This minimizes down time, and gives a speedier recovery, as much of the recovery after a facial surgery is actually recovery from the general anesthesia, which can interfere with your gut and muscles, making you feel nauseated and weak.  The cost of the procedure is also less when it is done in the office.

How is Recovery After a Neck Lift?

After a neck lift, the patient goes home with a facial wrap bandage, which is removed the first day after surgery.  After this, a soft jaw wrap is worn to support the skin while it heals, and this is worn for the next two weeks.  There is no heavy lifting for the first two weeks after surgery, and depending on the degree of work done at the muscular level, limiting head turning past 45 degrees may be advised.  This is to give the best results, as securing the platysma muscles is one of the surgical maneuvers that benefits the cosmetic outcome the most.  Some of the stitches are removed as early as 4 days after the surgery, and the remainder are removed 7 and 10 days after surgery.  There may be some swelling and bruising, but by the 2 week mark, most patients look non-surgical to the outside world, as any bruising likely has moved toward the chest and can be covered by clothing or make-up, and the swelling is not very noticeable at this point.

What is the Neck Lift’s Role in Facial Rejuvenation?

The neck lift is one procedure to sculpt the neck.  Depending on the patient’s goals, surgery may be combined with a chemical peel of the neck and décolletage for a rejuvenation of the skin, which the surgery does not address.  The neck lift is often combined with an upper eyelid lift to rejuvenate the eyes and to make the best use of the down time after surgery, as the eyes tend to show age around the same time as the neck.  Volume restoration in the form of fat grafting, fillers, or Sculptra, is often combined with the neck lift, as treating volume loss can have a profound effect on sculpting the aging face.