The Neck Only Lift
Written by Dr. Cross
The “Neck Only”, or Neck Lift, concept of face and neck lifting is a technique that has alluded most plastic surgeons. Dr. 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 over 50 “Neck Only” lifts every year.
“If neck laxity is what bothers a patient, they can absolutely achieve a beautiful result with a Neck Only lift” Kevin J. Cross, MD.
Are you a Neck Only Lift Candidate?
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 these patients. For many patients, however, aging or poor aesthetics is isolated completely to the neck region. For those, “Neck Only” lifting should be performed.
The neck only technique is very useful in young patients as well. These are people who commonly have always suffered from poor neck definition. In 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 30’s in this example demonstrates all of these elements.
This patient in her 30’s underwent a Neck Only Lift to combat the appearance of a weak chin and lack of definition. *Results May Vary
The Neck Only Lift at Cross Plastic Surgery
The Neck Lift procedure comes in two forms. The first option is for patients with good skin elasticity. For these patient, 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 only procedure is still possible as is 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.
The Neck Only Lift procedure is also possible for patients with poor skin elasticity as shown with this 76 year old patient. *Results May Vary
Downtime and Longevity of a Neck Only Lift
There is minimal bruising and swelling in a neck only lift and typically very little pain. 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, washing their hair and face as soon as a day and a half after the procedure. Make-up can be applied at that time. Walking and all normal activities can occur immediately after the procedure. Light exercising is started 5 days after the procedure and full exercising by day 10. While there is a spectrum of healing times, with some 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 1 week after the procedure, 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 50’s-70’s. 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, however, and even after 10-15 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.