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Neck Lift

What is a Neck Lift?

In some individuals, the neck is the first area to reveal their increasing age. Their neck develops crepe-like skin, it accumulates excess fat (a “Double Chin”), tight bands form in some areas and tone is lost in other regions of the neck, and a “Turkey Waddle” or turkey-like neck can form. For others who have achieved significant weight loss, excess loose skin that has lost its elasticity contributes to an exaggerated older neck appearance.

Time, gravity and chronic sun exposure all act together to produce typical changes in the neck as you age: loss of definition to the neck and jaw line, creation of an “obtuse” wide angle to the neck rather than a sharp and well-defined angle, formation of vertical “Platysmal Bands”, “Jowls” and sagging of the lower face.

A Neck Lift is a surgical procedure designed to specifically smooth the neck, correct and lift crepe-like skin and redefine the jaw line. A neck lift has many different features and options, all designed to help recontour the skin of the face and neck, tighten the underlying tissues and muscle, and remove excess skin.

Each neck lift technique, used in the right setting, has outcomes that are consistently reliable and long-lasting. The results are a reversal of the effects of gravity and gentle redraping of the soft tissues to restore a more youthful contour to the neck. Neck lift surgery is often combined with a Facelift to address both the face and neck and correct the visible signs of aging. The definitive goal of a neck lift is to look Refreshed, Natural and Rested, not to appear “done”, hollowed out or pulled too tight.

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Who is a Good Candidate for Neck Lift Surgery?

Good candidates for a neck lift include men or women who are healthy, in good physical shape, and at their ideal body weight (or a stable weight following major weight loss).

Smokers, patients with multiple or untreated medical problems, and individuals who are psychologically unprepared for surgery are not good candidates for a neck lift. Learn more about Preparing for Plastic Surgery in our Preoperative Instructions section.

A neck lift can be an extremely rewarding and empowering experience, but should be done at the right time and for the right reasons, by a Board-Certified Plastic Surgeon. Candidates for neck lift surgery should be emotionally stable, have the support of their surrounding friends and/or family members, and be fully educated about the procedure they are contemplating. Visit our Preoperative section to learn more.

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What Are the Different Types of Neck Lifts?

Traditional Neck Lift

A traditional neck lift makes use of three general components to treat the aging neck in an individualized, tailored approach:

  1. Liposuction of the neck eliminates excess fat from under the chin and the neck
  2. “Cervicoplasty” redrapes and removes excess baggy skin from the neck
  3. “Plastysmaplasty” corrects “banding” from redundant and loose plastysma muscle visible as sharp vertical lines in the neck.

The effect of a neck lift is reversal of the effects of aging, loss of elasticity and gravity on the neck, recreation of a well-defined jaw line, and repositioning of the soft tissues of the neck to a more youthful and smooth contour.

Liposuction of the Neck and Chin

Liposuction of the neck and chin removes excess fatty tissue stored in this area, creating better definition to the jaw line and neck. A small incision is hidden in the natural crease under the chin, and fat cells are permanently removed by a blunt-ended “cannula” (wand) and a vacuum. For individuals with only extra fat under the chin or along the jaw line without redundant skin or jowl formation, liposuction alone may be enough to rejuvenate the neck. Please visit our Liposuction section to learn more about this technique.

Cervicoplasty

A “cervicoplasty” procedure removes excess skin in the neck region using incisions in the natural fold beneath the chin and behind the ears. The skin of the neck is “elevated”, redraped in a smoother and tighter contour, and excess skin is trimmed. Please read below to learn more about this procedure.

Plastysmaplasty

Like the “SMAS” layer of the face, the “Plastysma” muscle is part of the “superficial musculo-aponeurotic system”. The plastysma is visible when you bear your lower teeth and depress your lower lip in the mirror; you will see vertical “plastysmal bands” form in the neck region. With age, these bands can become accentuated from loss of muscle tone, loss of elasticity and skin redundancy. Plastysmaplasty surgery tightens the muscles and recreates a smooth contour to the neck from the inside out.

During a plastysmaplasty, incisions are made under the chin, behind the ears or in both locations. The muscles of the neck are tightened, sutured together in the midline or realigned to create a smoother and more well-defined contour to the neck.

Lower Facelift

A “lower facelift” addresses the mid-face region in addition to the neck, and is essentially a combination of a Facelift and a neck lift. A lower facelift procedure corrects sagging jowls, loose neck skin and fatty accumulation beneath the chin but also rejuvenates the mid-face and cheeks. A lower facelift does not address the brow (forehead) or eyes.

Endoscopic Neck Lift

An “endoscopic” neck lift uses a rigid pencil-shaped probe with a small camera, inserted into the neck region through small incisions and tunneled beneath the skin. The endoscope enables visualization of the tissue beneath the skin on a video screen. This technique is sometimes used to help tighten the plastysma muscle, but it does not correct excess skin.

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What Really Happens During a Neck Lift?

Please see our Preparing for Surgery section to learn about what happens in the operating room on the day of surgery.

A neck lift is performed in the operating room under general anesthesia or intravenous (also known as “twilight”) sedation for optimal comfort, control and safety. Incisions are made under the chin and usually behind the ears, ending in the lower scalp behind the ear. If a Facelift is also being done, incisions will start in front of the ear in a natural crease and extend around the bottom of the earlobe before traveling behind the ear for access to the neck.

Liposuction is performed first to permanently remove excess fat from the neck and under the chin. The skin of the neck is then gently “elevated” off the deeper structures under surgical “loupe” magnification to protect delicate blood vessels and nerves. The neck plastysma muscle is repositioned and sculpted to create a more youthful contour to the jaw line and to correct “jowling”, known as Cervicoplasty. Dissolving stitches (“sutures”) are used wherever possible. Surgical staples may be placed in the hair-bearing scalp region for easy removal in a week or two in the office.

When you awake from your neck lift, soft dressings will be in place and you will be comfortable. Neck lift surgery is not normally very painful. Pain medication is prescribed for you to take after surgery as needed. A small, soft Drain may be placed to gently remove “wound fluid” under the skin for 1 to 3 days after surgery. An overnight stay may be recommended, depending on the details of surgery.

Neck lift incisions tend to heal very well with good quality scars due to the excellent blood supply of the facial and neck region and avoidance of tension on the skin closure. As mild swelling and any bruising subsides, visible improvements of the neck lift procedure will appear over a few weeks.

Neck lift Scars are permanent, but remain concealed in the natural contours of the neck, behind the ears and in the hairline. It takes several months up to a year for the final results to be evident and for all scars to become “mature”. As a component of Scar Therapy, it is important to minimize direct sun exposure to the face and neck not only during healing, but as a life-long behavior to help maintain your rejuvenated appearance and to minimize future “photo-aging” (sun damage).

The final effect of a neck lift is a natural, more youthful and toned neck that reflects the youthful, energetic and extraordinary person that you are!

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How Long Will the Results of a Neck Lift Last?

A neck lift will last forever, giving your neck a smoother, more youthful appearance that will endure in the long term. However, you will continue to age as appropriate after any type of facial Plastic Surgery. In the future, you will still appear younger than if you had not had your procedure, but you will never appear tight, “overdone” or abnormal.

Maintaining excellent Skin Care, smart sun avoidance and consideration of Non-Surgical Rejuvenative Procedures can often prolong the results of your neck lift. Long-term follow up with your surgeon will enable ongoing assessment of your results both in the short-term and over many years to come.

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Can other Surgical Procedures be Done Together with a Neck Lift?

A neck lift by itself makes improvements to the neck, the jaw line and possibly the mouth area but does not specifically address the mid-face, the forehead (“brow”) or the eyes. A complete facial examination will be done at your consultation to elucidate which surgical option(s) will best achieve your goals and most accurately treat your specific features of aging.

A neck lift is often complimented and further enhanced by a variety of Complimentary Facial Plastic Surgery Procedures, including a:

  • Facelift to smooth wrinkles and correct aging in the cheeks, mouth region and mid-face.
  • Brow Lift (Forehead Lift) to gently lift and refresh the brow, helping to create a more youthful appearance to the eyes.
  • Eyelid Lift (Blepharoplasty) to refresh and rejuvenate the eyes and remove excess, baggy upper or lower eyelid skin.
  • Otoplasty or Earlobe Correction to help balance the face and rejuvenate or repair aged or stretched-out earlobes.

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Are Non-Surgical Treatments Part of a Neck Lift?

Complimentary Non-Surgical Procedures are commonly added to a neck lift to enhance its success. Pre-treatment of the face with minimally invasive procedures or skin care regimens can promote the best aesthetic outcome of neck lift surgery, and help prolong its results.

Non-surgical procedures that may accompany a neck lift include:

  • Minimally Invasive Procedures such as Botox, fillers, lasers and other skin treatments to compliment and enhance neck lift surgery results.
  • Medical-Grade Skin Care adequately prepares the skin of the face and neck for surgery, assists in the recovery of the skin during the healing period, and in the long term, helps to prolong the results of surgery.
  • Medi-Spa Services can compliment facial Plastic Surgery and further pamper and rejuvenate the face, neck and décolletage (cleavage area).

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What is the Recovery After Neck Lift Surgery?

After any type of facial surgery, some swelling and bruising is expected. Initial asymmetry from swelling or an uneven appearance to the skin is quite common and will normalize as healing progresses. After approximately two weeks, obvious signs of surgery such as puffiness or discoloration should dissipate.

Sleeping with a few extra pillows to elevate the head can help speed the resolution of postop swelling. Strict sun avoidance and the regular use of sunblock of at least SPF 30 are vital to prevent permanent “hyperpigmentation” (darker color to the skin and incisions) and sunburn. Wearing makeup over sunblock is permitted at a week postoperatively and should continue as part of your morning beauty routine. Products that are recommended for postoperative skin protection are available at our office as part of our Medical-Grade Skin Care regime.

Prior to a neck lift, some patients grow their hair a little longer than usual if it is short to help conceal any incisions in front of the ear during healing. Any chemical hair coloring should be avoided for at least a month after surgery; splurging on a trip to the salon before a neck lift helps many patients prepare for surgery.

Any sutures or staples that do not dissolve on their own will be painlessly removed in the office within a week or two. Please see our Postoperative Instructions section and Special Instructions for Facial Surgery for additional information pertaining to recovery from a neck lift.

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What Are Potential Risks and Complications of Neck Lift Surgery?

When you are considering any type of surgery, you should be fully educated about potential risks and complications. Please see our Preparing for Surgery section to learn about general risks and potential complications, Special Considerations for Facial Plastic Surgery, and our section on Postoperative Instructions for additional information pertaining specifically to neck lift surgery.

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Before and after neck lift surgery results will be reviewed during your consultation.

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As women Plastic Surgeons, we intimately understand how an individual’s looks and their feelings about their appearance can influence self-image and self-esteem. At your neck lift consultation, your surgeon will spend a great deal of time with you to get to know you personally and take a complete medical history.

Your facial bone structure, underlying skin composition, skin thickness, texture and elasticity, extent of facial wrinkles and folds will be carefully examined. Taken together, this information will be used to formulate an individualized plan to address your unique features of aging and your specific aesthetic goals. Your Plastic Surgeon will select the surgical technique she feels will obtain the best outcome for you and that offers the lowest potential risk.

We will explore in detail your reasons for seeking a neck lift, and if you are an appropriate candidate for surgery, your options will be described in detail.

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Dr. Karen M. Horton, M.D. - Plastic Surgery, Physicians & Surgeons - Medical-M.D., San Francisco, CA