The skin around the neck is thinner and less elastic than facial skin. Neck skin is often overlooked in skin care regimens and sun protection protocols. Over time, neck skin loses its elasticity as a result of age, gravity, weight loss, and excessive sun exposure. The result is loose, hanging skin which can make you look much older than you feel. Indeed, the neck tends to age more quickly than the face, and patients comment that their necks look ten years older than their faces. These changes are compounded by the fact that the underlying neck muscles also lose tone, creating vertical cords and bands which contribute to the “turkey gobbler” neck.
In a neck lift, excess skin is removed, the muscles are tightened, and fat is meticulously removed to contour and smooth the neck for a more youthful appearance. Dr. Chung has extensive experience and expertise in the various approaches to neck lift. She feels that neck rejuvenation provides the most dramatic yet most natural-looking results. Although a neck lift cannot stop the aging process, it can create a youthful profile and appearance. Many patients choose to combine a neck lift with a mini-lift, lower face lift, or eyelid surgery to maximize results.
Am I a good candidate for a neck lift procedure?
If you wish to get rid of the extra skin and fat in your neck and are in good health, you are an excellent candidate for a neck lift. The potential reasons for desiring a neck lift are variable and highly individualized. Some patients are bothered by their “turkery gobbler” appearance. Others have achieved significant weight loss, resulting in excess loose skin around the neck. Still others simply wish to have better definition along their jawline and neck.
There is no “correct” age for a neck lift procedure. Younger patients may pursue a neck lift to improve the anatomy with which they are born, such as a short chin, fullness in their necks, and lack of definition. Older patients may pursue a neck lift to reverse the changes brought on by the aging process. As with all facial plastic surgery procedures, the timing of surgery depends on your skin type, hereditary traits, bone structure, and lifestyle choices, such as smoking and sun tanning. While younger patients may benefit from a one-hour submentoplasty (mini-neck lift in the office), older patients may benefit from more comprehensive procedures. Although Dr. Chung has performed primary neck lifts in patients as old as 80 years, she does not recommend that you wait too long, as the more advanced aging requires more extensive work and may limit the final outcome.
Ultimately, your wishes are important to Dr. Chung, who tailors her surgical techniques to your goals and desires. A neck lift cannot stop aging, nor can it turn back the clock. What it can do is help your neck look its best, giving you a healthy, more youthful appearance.
What happens during my initial consultation for a neck lift?
During your initial consultation, Dr. Chung will listen to your concerns and perform a thorough evaluation of your bone structure, skin tone, skin elasticity, and amount of fat accumulation in the neck. She will also take a thorough medical history to assess for conditions such as hypertension, cardiac issues, diabetes, and smoking. It is important to tell Dr. Chung of any previous neck surgeries, as well as any plans for significant weight loss. During the physical exam, Dr. Chung will evaluate the integrity of your jawline and the position of the hyoid bone. These bony structures are extremely important in setting realistic expectations for surgery. During the initial consultation, Dr. Chung may also recommend a chin implant to improve the appearance of the jawline, neck, and jowls.
Depending on the appearance of other parts of the face, such as lower face and skin, Dr. Chung may recommend additional procedures, such as a lower face lift, mini-lift, or a skin resurfacing procedure. It is important to remember that all elements of the face work in harmony to create one unified look. Ultimately, the decision regarding which procedure will provide you with the best results will be made after careful evaluation and discussion, carefully considering your goals and personal preferences.
What happens during my neck lift procedure?
Neck lifts are routinely performed under local anesthesia in the office. They may also be performed in the hospital under light sedation depending on your health, personal preference, and number of planned additional procedures. Before the procedure, Dr. Chung will review your preoperative photos with you, as well as the surgical plan. The conventional neck lift incision is placed under the chin and behind the ear. The length and position of these incisions depend upon the amount of loose skin that needs to be lifted. All incisions will be strategically placed within natural creases, making them barely visible once healed. After the skin incision is made, Dr. Chung separates the skin from the underlying fat and muscle. The fat is meticulously removed by liposuction and hand sculpting; this attention to detail allows Dr. Chung to create sharp definition to your jawline and neck. Once the fat has been removed, the underlying muscle (platysma) is tightened. As the platysma muscle ages, it loosens and creates vertical cords and bands in the neck. This “platysmaplasty” addresses these vertical bands, creating a smooth, youthful appearance. Any loose, excess skin is then lifted and removed behind the ears. All incisions are closed meticulously with fine stitches. Your head will be wrapped with a large dressing. Dr. Chung will be change your dressing in 1-2 days in the office.
Corset plastysmaplasty allows for significant tightening of the platysma muscle, creating a beautiful and smooth contour to the neck. In this advanced technique, the medial ends of the platysma muscle are joined together with a continuous suture running almost the entire length of the platysma muscle to create a multilayered seam. Like a woman’s corset, the continuous suture pulls the ends of the platysma together, creating a tight, smooth muscle layer. This technique requires meticulous stitching, more time, and adds another level of complexity to the procedure.
Sub-Platysmal Fat Sculpting
In a neck lift, most plastic surgeons only remove the fat that lies on top of the platysma muscle, as this fat may be removed by liposuction and is free of any important anatomic structures. As a double board certified facial plastic surgeon who specializes in the face and neck region, Dr. Chung is routinely removes fat that lies deep to the platysma muscle. This attention to detail and advanced technique significantly improves the results and distinguishes Dr. Chung’s surgical outcomes from others.
You may also benefit from other procedures –such as a lower face lift or mini-lift –at the same time as your face lift for a harmonious facial rejuvenation. Skin resurfacing procedures, such as a chemical peel or fractional laser treatment, are also commonly performed at same time to improve the skin tone and texture. Some patients also benefit from the placement of a chin implant at the same time as a necklift; the implant may be placed through the same incision and will create better definition of the jawline and neck.
What is the recovery like?
The recovery from a neck lift alone is quicker than if combined with a face lifting procedure. The incisions are shorter and there is less downtime. Immediately after surgery, there will be some swelling and bruising. This will get a little worse over the next 2 days before it gets better. You will apply ice to your face for 48 hours. After 48 hours, you may remove your head dressing, take a shower, and wash your hair. Most patients do not require any pain medications after a few days. You will clean your incisions with hydrogen peroxide and apply antibiotic ointment to the suture lines. The stitches are removed in 5-7 days after surgery. Once the stitches are removed, you may use makeup but need to be careful when removing the makeup so as not to pull on the incision line. Most patients return to work and social activities 1 week after surgery. Exercise may slowly be resumed a week after surgery. It is also normal to feel tightness in the neck and this will improve over time.
What will I look like?
The majority of the swelling and bruising will be gone in 1 -2 weeks, and there will be continued improvement for several months. The incision will also be slightly pink for a few months, but will fade and ultimately become barely visible. Most people will not even know you’ve had neck surgery! You will have a wonderful refreshed quality, and those around you will comment that you look “rested” and “rejuvenated,” but will not be able to place their finger on the cause. You may also look as if you have lost weight. With a neck lift procedure, you will experience firsthand how an improved look will inspire an improved outlook.
“You can always tell a woman’s age by her neck and hands.”