I have always said and taught other plastic surgeons that “the more beautiful the neck, the more graceful the face.” It is something I always remember when I perform facelifts and neck lifts. Indeed, the two go hand-in-glove. Aging of the neck begins to become visible, sadly, in the late 20’s. Often, it is just a glimpse of a slight pouch on the side of the mouth, a little fullness where, soon enough, a jowl will manifest itself. Sometimes, it is just a little puffiness below the chin, an early fold of skin or band of muscle in the neck. By the 30’s and 40’s, such changes advance, not helped by the inevitable injury caused by ultraviolet light. The fact that most of us forget to protect the skin of the neck and chest with sunscreen conspires to exacerbate the aging changes, with thicker, more sun-damaged skin, fine and medium wrinkles, brown and red spots, broken vessels and lack of elasticity. For too long, surgeons have concentrated on performing facelifts, but neglecting the importance of paying just as much attention to the neck and chest. Surgically as well as with lotions, potions and lasers to improve the condition of the skin.
Someone (female), once said “my biggest mistake in life was not enjoying my beautiful neck every single day in my 20’s and 30’s. Oh, how I took it for granted!”
Necklifts
Aging of the neck presents in many different forms, from changes in the skin, to muscles, to deeper structures like submandibular glands and fat. There are myriad techniques we use for the improvement of these many changes.
Neck rejuvenation and contouring procedures are challenging and continually advancing. Although the techniques are evolving, the anatomy is constant, and surgeons with a firm understanding of the anatomic relationships within the neck are able to deliver consistent and aesthetically pleasing results for their patients.
Neck rejuvenation and contouring procedures are challenging and continually advancing. Although the techniques are evolving, the anatomy is constant, and surgeons with a firm understanding of the anatomic relationships within the neck are able to deliver consistent and aesthetically pleasing results for their patients.
"Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love..." D. Rock 63 Yrs Old with Fat Droopy Eyes - Salt Lake City, UT
What is a Neck Lift?
On occasion, an isolated neck lift is possible. More often, it is performed in conjunction with a lower face lift. Isolated neck lifts take many forms, depending upon the changes that may be present and addressed. Limited incisions behind the ears are sometimes employed to tighten some of the loose neck skin. However, a complete neck rejuvenation is rarely possible with limited incisions. A submental incision (incision hidden below the chin) is also used to remove fatty deposits in this area and to tighten muscle bands. Finally, Giampappa sutures are employed: these are criss-cross sutures which allow tightening of the deeper structures and fixation to the tissues behind the ear (mastoid fascia). As can be seen, isolated neck lift procedures take varied forms.
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Am I a Candidate for a Neck Lift?Patients that are good candidates for an isolated neck lift are patients with the following:
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This patient had neck liposuction and the use of Giampappa sutures to give her a partial improvement of her neck. Surgery was also performed on the upper two-thirds of her face (brow lifts, upper and lower blepharoplasty and cheek lifts, that we designed and call the Hammock Lift
why the neck?People divide the face and the neck, but the appearance of the neck has a huge bearing on the appearance of the face.
In the illustration to the right, I have only changed the fullness of the neck. The secondary effects make the face look much older. So it pays to define the neck as best as one can. By choosing to do an isolated neck procedure with lasers or surgery, you will get some improvement of the neck and the face. By choosing to going for the whole Monty and improving the neck properly with a defined facelift and necklift, you get the best results! |
"I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm." D. Gull Highly recommended for eye lift surgery - Salt Lake City, UT
How will I be Assessed?
Examination of the neck structures as described under the “Conditions” Neck section will allow one to determine if an isolated neck rejuvenation procedure is a reasonable option. It is important to remember that with the neck, tissue restitution occurs: this is a concept that is not well-known in plastic surgery or, is at least not well appreciated. Essentially, what you see immediately after surgery is NOT what you get in the medium or long term. The skin of the neck and décolleté is prone to develop fine lines, deep-set lines, loss of skin elasticity and discoloration. Neck skin is thinner than facial skin. The face has 30 times the pilosebaceous units than the neck or chest and 40 times that of the hands and arms. Therefore, neck skin responds more slowly to any surface skin treatments like lasers and chemical peels.
examples of isolated necklifts and explanation of results
What other Procedures May be Performed with a Neck Lift?The commonest procedure performed at the same time as a neck lift is a face lift. This combination gives a congruous improvement from the midface all the way down to the neck. Other procedures include liposuction of the neck, chin augmentation and platysma plication.
This patient had a Hammock lift with neck liposuction which gives her an improvement in the jawline and neck without a full facelift and necklift. |
Isolated Necklift Procedures ExplainedThis patient had an isolated necklift procedure where liposuction, Giampappa sutures to tighten the tendons and excision of a small amount of skin behind the ears was done. This was not a full facelift and necklift so you can see that although there is an improvement in the neck, there is still some laxity and presence of jowls.
However, the patient has a more defined neck and a better jawline. This procedure takes about one hour and 30 minutes (compared to a full facelift and necklift which takes 3 to 5 hours and is more involved) |
Another example with explanationWe performed a Hammock Lift which includes manipulation of the brow shape, upper and lower blepharoplasty and cheek lifts, which gives her the nice improvement in the top two-thirds of the face.
The improvement in the neck is from liposuction and limited incision neck tightening. Again, not as great a result with the neck as we can get with a proper facelift and necklift, but an excellent result with an isolated neck procedure. Patient sent her sister in for the same procedures! |
by comparison, you can see the more pronounced improvement in the neck (and lower face) with a full facelift and neckliftThese photos allow you to compare the more definitive results that may be obtained with a proper facelift and necklift. It is important to understand the differences in results with more limited procedures. Caveat Emptor!
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For the best resultsWe performed a full facelift and necklift which includes improvement in the cheeks, lower face, jowls, jawline, neck and the texture of the skin. Improvement is sought in the lip lines, lip fullness, cheek fullness and a youthful chin. Only by combining all these improvements can an overall excellent result be obtained.
The gold standard gives golden results! |
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Frequently Asked Questions
Where will my surgery be performed?
Most neck lifts are performed in an operating theatre for the sake of sterility and your comfort.
What kind of anesthesia will be used?
Isolated neck lifts may be performed with sedation anesthesia or general anesthesia.
What kind of sutures are used?
Most sutures used during a neck lift will be removed in one to two weeks. Deeper sutures used to address the platysmal bands dissolve slowly over many months.
Do you use lasers for this surgery?
The use of resurfacing lasers at the same time as undermining tissues in the neck is unwise. We can use fractionated lasers at a later date to improve the texture of the skin.
How long does the surgery take?
Most midface lift procedures take 60 to 90 minutes operating time.
How much bruising and swelling will I have?
Bruising is limited to the neck. There is minor swelling. We will have you use a neck dressing which provides pressure on the operated site, thereby reducing the amount of bruising and swelling. Again, the use of ice on-and-off for the first few days helps.
Does insurance cover Neck lifts?
Cosmetic surgical procedures are never covered by insurance.
How painful is Neck lift surgery?
There will be mild to moderate discomfort after surgery: prescription pain medication is usually only necessary for one to two days. There will be generalized decrease in sensation over the neck because of the extent of undermining of the tissues: this improves over weeks to months.
Are there any restrictions and when may I return to work?
You will wear the neck dressing every night for two weeks and as much as you can during the day for those two weeks. Most patients can resume normal activity within a few days, including returning to work.
What are the most common risks of Neck Lifts?
One must mostly remember that the results will be limited. You may find that some of the laxity of the neck skin and deeper bands remains after surgery. Serious side effects are rare after this type of surgery.
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Dr. BCK Patel MD, FRCS 1025E 3300S Salt Lake City, Utah 84106, USA (801) 413-3599 (phone/text) E: [email protected] bckpatel.info Locations:
Dr. BCK Patel MD, FRCS 585 E Riverside Dr Suite 201 Saint George, UT 84790 (435) 215-0014 E: [email protected] Quick-Link |
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