Neck Lift Surgery
OverviewMany people find that their neck shows signs of aging well before the rest of their face. Heredity and weight loss can also impact the appearance of the neck. Common concerns include horizontal bands or lines, loose-hanging skin, and excess fat deposits which give the neck an undesired appearance. Fortunately, a neck lift can minimize these effects by lifting and tightening the soft tissues of the neck giving patients a firmer and more youthful-looking neck. In fact, the hope of achieving a more youthful neckline is one of the most common reasons people seek facial plastic surgery. (1) If you have excess fat in the lower face or chin, have loose skin in the neck, or notice muscle banding creating abnormal contouring, a neck lift may be right for you.
After age 40, our skin begins to lose some of its elasticity due to hormonal changes and slowed healing processes. This causes skin to stretch when moved, but not return to its normal, supple state after. Instead, it presents as excess skin. In addition, our jaw and neck muscles begin to atrophy, or shrink in size, which changes the tone and shape of the jawline. (2) Adipose tissue, or fat, begins to accumulate at a higher rate under the skin, causing unappealing contour in the highly visible neck region. (2) These factors combine to cause the cervicomental angle (the side angle between the neck and the lower jaw) to change and become less defined, sometimes creating a double chin.
A neck lift is a surgical procedure with the goal of creating a more youthful appearance of the neck. (3) Plastic surgeons may use a variety of different procedures based on the individual’s goals, anatomy, and skin condition. When considering a neck lift, you should consult with your plastic surgeon regarding the appropriate procedure for you. Two procedures dominate in popularity, based on skin integrity and facial shape.
- Lower rhytidectomy: the gold standard in neck lifts, this technique involves liposuction, submentoplasty, skin removal, and pulling skin tighter. (2)
- Submentoplasty: this less invasive technique involves an incision, liposuction, surgery on the platysma muscle, and no skin removal. (2)
Some plastic surgeons will only perform lower rhytidectomy, as they feel several anatomical problems are ignored when there is no skin removal. (4)
The platysma is the muscle that stretches like a broad sheet from the collarbone to the jaw. It functions in creating facial expressions. During the youthful years, it appears relatively smooth and flat; its name in Greek actually means flat plate. As the neck ages, the platysma begins to take on the appearance of bands, or cordlike vertical tendons which causes the neck to look aged. These vertical bands can intersect the horizontal neck creases, which further punctuate the sagging look. In neck lift procedures, the plastic surgeon tightens the platysma. However, the bands can return over time (typically 10-15 years).
The targeted results of a neck lift include:
- A smooth, contoured neckline
- Improved skin firmness
- Elimination of saggy skin on neck
- Enhanced overall appearance
- A more youthful look
- A more defined jawline
- Improved balance of facial features.
If you are not ready for a full facelift but want to rejuvenate your neckline and skin quality, a neck lift is a viable treatment option. People who are healthy nonsmokers with no medical conditions that impair healing are good candidates for neck lifts. It is important to discuss options and expectations with your plastic surgeon to keep a positive outlook and achieve desired results.
There are many other treatment options that exist to treat aging, saggy skin around the neck but may have limited effect depending on the degree of skin sagging and excess fat deposits. Some non-surgical neck lift options include:
- CoolSculpting (CoolMini): coolsculpting is a device designed that freezes and eliminates fat cells through a process referred to as cryolipolysis.
- Injectable Neuromodulators: injections are used to help tighten the look of the neck (Botox, Dysport, etc)
- Injectable Dermal Fillers: fillers add mass that helps plump up and fill in wrinkles. When injected along the jawline, fillers can also help lift the skin and make it appear tighter. Examples of fillers used for the neck include Juvederm Volbella and Restylane Silk and Refyne.
- Ultherapy: ultherapy is a type of ultrasound technology that lifts and tightens skin.
- Laser Treatments: laser procedures stimulate collagen production. As a result, skin gradually appears smoother and more vibrant in the treatment area.
- ThermiTight: a minimally invasive method that tightens loose skin and deeper tissues. It is commonly used in the neck and lower face to lift the jowls. ThermiTight is sometimes combined with liposuction for fat removal.
- Kybella: Kybella is an FDA-approved injectable that eliminates fat cells under the chin to improve your profile.
If you have already tried a neck lift and have recurring platysmal banding, another option for treatment is botulinum toxin injections (Botox). (2)
Risks and side effects
When undergoing a neck lift, you will be given the option of local or general anesthesia. Most patients opt for general, as the procedure can take 2-3 hours to complete. Anytime the body undergoes general anesthesia, there are risks associated. They include, but are not limited to:
- Allergic reaction
- Deep vein thrombosis (DVT)
- Heart attack
- Increases in blood pressure or body temperature
The risks are small, but worth noting when discussing treatment options. The side effects associated with a neck lift pertain to the skin and muscle tissue that is manipulated during surgery. Some of these potential side effects may include: (2)
- Seromas (collections of fluid under the surface of the skin)
- Prolonged swelling
- Skin irregularities and discoloration
- Facial asymmetry
- Temporary or permanent hair loss along the incision
- Numbness, facial nerve damage
- Poor wound healing.
On rare occasions, a suture may surface through the skin and need to be removed. Another risk to consider is dissatisfaction with the results following surgery and full recovery. Patients may opt to return for a facelift or add implants to the chin if they have not yet achieved their desired look.
According to the American Society of Plastic Surgeons (ASPS), the average surgeon’s fee for neck lift in the U.S. in 2019 was $5,110. (5) However, this does not include the costs for the hospital/operating facility and the anesthetist. If you’re ready to recreate that beautiful jawline you once had, but aren’t quite ready for a full facelift procedure, talk to your doctor today. A neck lift may be the answer to looking as youthful and vibrant as you feel.