Focus on Specific Signs of Aging in the Philadelphia, PA, Area
The "neck only" or neck lift concept of face and neck lifting is a technique that has eluded most plastic surgeons. Dr. Kevin Cross frequently hears from patients who were told by other surgeons that it is impossible to correct just the neck, and that a neck lift must include a facelift to be effective or to look good. That statement is not true. In fact, Dr. Cross performs more than 50 neck lifts every year for patients from all over the Philadelphia area.
As per Dr. Cross, "If neck laxity is what bothers a patient, they can absolutely achieve a beautiful result with a neck only lift."
Are You a Candidate for Neck Lift Surgery?
For many patients, the aging process largely involves the neck, but the jowls and jaw line are affected as well. In these patients, a correction of the lowest part of the face along with the neck will provide the most balanced and harmonious result. For some patients, however, aging or poor aesthetics is isolated completely to the neck region. For those, "Neck Only" lifting should be performed.
The neck lift technique is very useful in young patients as well. These are people who have commonly suffered from poor neck definition. For these patients, hereditary differences in their anatomy prevent a well-defined jaw line and neck from ever developing. The lack of definition may be combined with the appearance of a weak chin. Both can be corrected with a neck lift. The patient in her 30s in this example demonstrates all of these elements.
The Neck Lift at Cross Plastic Surgery
Neck lift surgery comes in two forms: The first option is for patients with good skin elasticity. For these patients, three incisions, each the length of a thumbnail, are used. One is hidden under the chin, and one is hidden behind each ear. The key to a successful neck lift result is making corrections to multiple areas under the skin.
Most important to the result is manipulation of a thin muscle that lies just under the skin, called the platysma muscle. During a procedure with Dr. Cross, this muscle is tightened in two directions: from behind each ear and from the small incision under the chin, as demonstrated in this diagram.
Tightening this muscle from under the chin—like a corset is tightened around the waist—results in a well-defined silhouette in the region under the chin. Sculpting of fat, both above and below the platysma muscle, further helps define the neck. Finally, modifying areas previously thought uncorrectable under the chin allows complete control of the neck appearance. This includes thinning bulky, redundant muscles called the digastric muscles, and reducing bulges that are created by sagging glands known as the submandibular glands.
For patients with poor elasticity, a neck lift is still possible as shown in this 76-year-old male patient with very poor skin quality. The best option for these patients, however, includes removal of excess skin from incisions placed behind the ear in addition to the fat, muscle, and sometimes gland work.
Downtime Required and Longevity of a Neck Lift
There is minimal bruising and swelling after neck lift surgery, and typically very little pain. Neck lift patients will experience a significant amount of tightness under the chin from their anatomy being put back where it belongs. This tightness does not prevent opening of the mouth, swallowing, or eating, and starts to resolve over the first week. Patients can start showering and washing their hair and face as soon as a day and a half after the procedure. Makeup can be applied at that time. Walking and all normal activities can occur immediately after the procedure.
Light exercise is started five days after the procedure, and full exercise by day 10. While there is a spectrum of healing times—with some neck lift patients healing very quickly, and others more slowly—the majority of patients who undergo a neck-only lift will start to feel comfortable being out and seen socially around 10 days after the procedure.
External sutures are removed one week after neck lift surgery, and during this visit, office techniques are used to help resolve any residual bruising or swelling.
There is no expiration date on a neck lift procedure. For young patients, where the technique is used to establish proper anatomy when that anatomy did not exist, the result will last decades, until the aging process starts to cause laxity in their 50s to 70s. For patients who developed neck laxity as a result of aging, the aging process continues from the second the procedure ends. Patients now age from a new starting place. Even after 10 to 15 years, when these patients look in the mirror, while they will start to see some of the loosening that initially brought them to the office, their appearance will still typically look more youthful than it did prior to the initial procedure.
Other Options to Address an Aging Neck
Some patient are not prepared to choose neck lift surgery, but still want to make changes to that area. Ultherapy® uses ultrasound energy to tighten and firm targeted tissues without the need for incisions. The results are not as dramatic as surgery, but can work well on moderate laxity.
Patients who have a double chin may opt for Kybella®, an injectable fat-reduction treatment used specifically in the submental (below-the-chin) area. For more dramatic results that can be seen more quickly, liposuction is an effective choice.