A common complaint amongst both women and men is the loss of contour and neck definition, that occurs through the ageing process.
Neck lift surgery can be a powerful tool in correcting the signs of ageing and achieving a well-contoured neck.
Understanding the Neck Lift Procedure
The two most common approaches to correcting the neck involve either liposuction or neck lift surgery. Your surgeon will help you decide on the best option, but the principle deciding factor relates to the quality of your skin tone. Generally, if you have good skin tone, then liposuction alone can achieve improved neck contour by removing unwanted fatty deposits. Liposuction procedures, however, rely on the skin’s ability to retract back (after the fat has been sucked out) to ensure that you are not left with loose hanging skin. If skin tone is limited, then a neck lift procedure is generally required to improve neck contour.
The vast majority of age-related changes that occur in the neck region are related to poor skin tone and neck muscle tone. Neck lift surgery can therefore be used to address these changes. As we age, skin tone reduces, leading to laxity and descent of the skin. When significant, this can lead to a large flap of loose neck skin that is sometimes described as a ‘Turkey neck’.
It is important to understand that the neck also contains a thin muscle that is attached to the skin – this is known as the platysma muscle. Over time, changes in the platysma muscle can lead to many of the unwanted signs of ageing in the neck. Neck lift surgery frequently entails tightening, dividing, or re-suspending the platysma muscle.
Furthermore, if one is to comprehensively correct poor neck contour the unwanted changes seen in an ageing neck it is important that the causative factors are first identified and then corrected. Contributing factors include fatty tissue deposits, salivary glands, and muscles that form the floor of the neck. If the individual factors are left untreated, the results are likely to be short term and limited. It is therefore important that you see a surgeon that is competent in identifying and correcting the specific factors that are responsible for these changes.
An experienced surgeon should also be able to modify the surgical techniques required to correct the causative factors rather than simply applying a stock standard approach to neck lift surgery. It is this approach that will lead to a positive and long-lasting outcome. This skill is also what distinguishes a good result from an excellent one. It may also explain the differences in cost and time taken to perform the procedure.
A surgeon saying that they are able to perform your neck lift in 2-3 hours rather than 4-6 hours is not necessarily a good thing. Experienced surgeons typically spend 4 – 6 hours or more meticulously performing your procedure to achieve a desirable outcome. This is in keeping with my philosophy as….
‘It is always my desire to produce a neck that is beautifully contoured and proportioned. This means understanding the fine little nuances and modifying techniques that ensure the neck is tailored in a highly aesthetic manner.”
This means that your neck lift consultation should be more than just your surgeon advising you that the skin or neck muscles have become loose and need to be retightened and lifted. Whilst these factors certainly need to be addressed, it is often the activity of the platysma muscle, the amount of submental (under chin) fat, the position of your chin, the prominence of your submandibular (salivary) glands, the presence of prominent thyroid cartilage (Adams Apple), and digastric muscle fullness that all needed to be considered and managed to achieve optimal results.
A successful neck lift procedure is more than just simply pulling up the loose neck skin. It is only by considering all of the necessary factors that true correction and optimal neck contours can be achieved.
A range of surgical techniques may be used during a neck lift operation to address the skin, fat and/or muscle. Certain cases may require additional procedures to address prominent neck muscles or glands.
A neck lift procedure may also be performed to correct other age-related changes, including removal of unwanted fat deposits surrounding the neck region, correcting a “double chin” and jowling. Some individuals suffer from prominent banding along the front of the neck due to a separation of the normal neck musculature from the midline. This can usually be addressed with a submentoplasty (a type of neck lift procedure) and a platysmoplasty procedure via a small hidden incision under the chin.
Dr Reddy will formulate a treatment plan that is suitable for your specific neck shape and one that best addresses your needs and concerns.
If you have excess hanging neck skin and or a full neck due to fatty deposits, then you are likely to be a good candidate for this procedure.
A general anaesthetic is used for the neck lift procedure, so you will be asleep for the duration of the treatment. Before you are put under anaesthesia, Dr Reddy will draw out the planned locations of the incisions and confirm these with you again. Once you’re under anaesthesia, incisions are neatly placed in the natural crease lines and hairlines to reduce their visibility.
Very often, short scar procedures are advertised by clinics, creating the perception that scarring will be less visible and more favourable. This is not necessarily the case and I often spend time educating my patients about scar techniques and outcomes to ensure they have realistic expectations. I would at this point say that a longer, well-concealed scar can be far more cosmetically superior to a short scar with improper contouring.
If placed correctly, scars will be much more favourable and less visible compared to one that has been tightly opposed or bunched together with less than ideal contouring. Incision length should be tailored to the amount of skin removal that needs to be performed and not dictated by the premise of wanting to perform a ‘short scar’ technique.
Think of it as dressmaking – excess cloth needs to be removed rather than stitched into a confined length, otherwise bunching of the material occurs. Similarly, excess skin that is not removed and is forced into a smaller than necessary incision will lead to skin bunching and poor contours. As a result, the potential benefit of the short scar technique is outweighed by poor contours.
Once the skin pattern is determined, the neck skin is lifted away from the underlying platysma muscle. The platysma muscle is a thin, fan-shaped muscle that contributes to neck contour. The two platysma muscle segments that sit on either side of the neck have often separated away from each other in the midline. They are therefore routinely sutured together in the midline – this is known as ‘platysmal plication’. In some cases, a part or the entire width of the muscle is also divided horizontally to treat any ‘platysmal bands’ that have formed. This is known as ‘platysmal transection’.
Following the above, the outermost edge of the platysma muscle is anchored to the firm tissues behind the ear – this is known as platysmal suspension. By suspending the muscle, your surgeon no longer relies on the skin to achieve the ‘neck lift’. Hence, it is simplistic to believe that lifting the loose skin alone will lead to long-lasting improvements. By suspending the muscle, tension in the overlying skin is kept to a minimum. Tension-free closure in the skin is important for achieving a good result. This minimises the chance of spread scars, pulled ear lobes and downward scar migration. i.e. all the tell-tale signs of a poorly performed facelift or neck lift.
Following platysma muscle plication and platysma suspension, the skin is re-draped and the excess neck skin is trimmed. The skin edges are then sutured together using a combination of non-dissolving and dissolving sutures. The surgical wounds are then dressed and a compression garment is applied.
Neck lift surgery can be combined with other facial procedures such as eyelid surgery, facelift, and rhinoplasty surgery. Whilst neck lift surgery can effectively address the jawline and neck region often be used to define the jawline, correction of the midface, requires procedures such as a midface lift or volume augmentation with fat grafting. It is therefore important to carefully consider why one is having the surgery. If it is simply to address one’s sagging neck skin, then a neck lift procedure will be very effective for this.
If the reason for surgery is to also rejuvenate and restore a more youthful appearance to the facial region, you must consider that this may require a more comprehensive approach, entailing face liftings or eyelid surgery too.
Neck Lift Before and After
Neck Lift Surgery | North Shore, Norwest and Westmead Sydney
To learn more information about neck lift surgery and what it can do for you, please contact us.
Every patient is unique and results may vary. Surgery and all health regulated services carry risks which need to be discussed with your doctor to ensure you are fully informed and realistic outcomes have been explained.