Neck Lift Surgery - Is It for You?
Reviewed by Timothy R. Miller, MD
Although other cosmetic surgical procedures may get more attention, perhaps neck lift surgery should be the one you consider first. After all, your neck is often the first place to show your real age.
The first signs of an aging neck usually become evident in our forties, and may appear as sagging or loosening of the skin below the chin or jaw. Some will notice cords or bands (the "weakening" of the platysma muscle) and possibly the development of a "turkey neck" or "turkey wattle." With time, neck fullness and sagging tissues can progress to the point where the youthful definition of the jawline is blurred or lost altogether. And it's not just advancing age that can affect the look of your neck. Even at a young age, excessive hereditary fat deposits located underneath the chin may enlarge and lead to the dreaded double or even triple chin.
Whether your neck is affected by age, your genes, the pull of gravity or the harsh effects of the sun and wind, neck lift surgery (platysmaplasty) or other neck contouring and rejuvenation procedures may be options. In a nutshell, a neck lift removes excess sagging skin under your jawline and on your neck. For those with bands or cords, the neck lift may involve adjusting and tightening the platysma muscle, if it has begun to separate and sag. If needed, the neck lift can include the removal or contouring of excess fatty tissue, some of which may be located below your platysma muscle.
If you only have excess fat under your chin or along your jawline, chin liposuction alone may be enough to enhance the appearance of your neck. However, be aware that as we move into our forties and fifties most necks will require more than just liposuction alone and will typically require a neck lift. A consultation with your surgeon will provide you with your best treatment option. Another emerging option is lipodissolve. This experimental "fat-melting" technology is also known as mesotherapy or injection lipolysis. It involves a series of medicated injections that may melt away unwanted small, localized areas of fat such as those in your chin (submental) area. However, most facial plastic surgeons do not recommend this treatment at the current time.
Are You a Candidate for a Neck Lift?
If you have jowls, a double chin, a turkey wattle or any other cosmetic concerns about the appearance of your neck, seek a consultation with a board-certified facial plastic surgeon.
During this consultation, your surgeon will take a thorough medical history to see if you are healthy enough to undergo neck surgery. Don't hold back. Mention any past surgeries and/or drug allergies or problems with anesthesia. Tell your surgeon about any and all medications you take on a regular basis. This includes supplements. Many medications and herbal or dietary supplements interact negatively with anesthesia and other drugs.
You must have realistic expectations about your neck lift, and what it can do for your appearance and your life. You also must be able to clearly communicate your aesthetic goals to your surgeon. After a frank discussion, your surgeon can determine whether your goals are realistic and can be met with a neck lift.
There will also be a physical component to this visit. Your surgeon will assess the amount of excess fat or loose skin in your neck area as well as the quality of your skin and muscle tone in this area.
Your surgeon will make suggestions regarding your neck lift, including the recommended technique, anesthesia and incision placement options. He or she should also discuss neck lift risks, neck lift recovery and neck lift cost.
Some surgeons charge for consultations, others don't. The consultation fee may be deducted from the neck lift cost if you decide to book a surgery. You should not feel pressured to book a neck lift on the day of your consultation.
The next step in the process is your preoperative appointment. This visit allows you to ask more questions and revisit any concerns you have about your neck surgery. You should also be given clear instructions about what you can and can't do in the days and weeks leading up to your neck lift, such as avoiding alcohol and not taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen. (NSAIDs increase your risk of bleeding.) If you smoke, quitting before your neck lift is important. Smoking impairs circulation and wound healing. Ask your surgeon which smoking cessation tools are most appropriate. You may also be given prescriptions for antibiotics and pain relievers to fill before your surgery.
Routine blood work and a physical exam may be required before your neck surgery. These measures are in your best interest and will help make sure you are healthy enough to undergo neck surgery. If you are a woman, you may be asked to take a pregnancy test.
Your Neck Lift: What to Expect
Your surgeon will explain the techniques for a neck lift and incision placements that would be most appropriate for you. He or she must discuss all the risks associated with neck lift with you, as well.
Your surgeon or members of his or her staff will start an intravenous (IV) line to administer fluids and medications. You will also be hooked up to monitors that will track your vital statistics during your neck lift. You may be given an oral sedative to keep you calm.
Your surgeon may mark up the areas on your neck and/or face before beginning the neck lift.
If you are having a "skin-only" neck lift, your surgeon makes two incisions under or behind the ear and then loosens the skin and redrapes it before removing any excess skin. If you are having a platysmaplasty with a skin lift, you may have a small incision under the chin along with the ones behind or under your ear. With a platysmaplasty, a section of the platysma muscle may be removed. Your surgeon will then rearrange and tighten the remaining muscle to improve the look of the neck and throat area. He or she will also loosen and redrape your neck skin as in a skin-only neck lift. Some surgeons prefer to perform a neck lift using sutures, mesh, or other materials as a sort of hammock to keep the neck tight and eliminate that turkey wattle look.
Once the neck lift is completed, your surgeon will close your incisions with sutures or tissue glue. You will have a pressure dressing wrapped around the top of your head to underneath your chin before you are brought into the recovery room.
About the Reviewer of this Article
Timothy R. Miller, MD, is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery. His practice, Facial Aesthetic Concepts, is devoted exclusively to aesthetic surgery of the face and neck. Dr. Miller has offices throughout Orange County, Calif., and has operating privileges at many area hospitals, including the Mission Regional Medical Center in Mission Viejo, Calif., Saddleback Memorial Hospital San Clemente Campus in San Clemente, Calif., and the Pacific Coast Ambulatory Surgicenter in San Clemente, Calif.
Dr. Miller received his medical degree from the University of California, Davis School of Medicine, and completed a five-year surgical residency in Otolaryngology-Head and Neck Surgery at the University of Utah School of Medicine, followed by a facial plastic and reconstructive surgery fellowship accredited by the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Miller is a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery and the California Society of Facial Plastic Surgery.
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