Often the first sign of aging is a loose neck, whether a result of gravity, loss of collagen, sun exposure, or weight loss. A neck lift helps tighten an aging neck by reshaping and repositioning loose, sagging skin and muscle as well as reducing fat deposits under the chin and within the jowls. Unlike lasers, Ulthera, Thermage, topical treatments, or injectable fillers, a necklift repositions and reshapes the deeper structures of the neck, minimizing the signs of aging by redefining the jawline and neck to create a smoother, younger appearance. The procedure both removes excess skin as well as tightens the muscles of the neck. Liposuction is sometimes used during a neck lift to remove excess fat under the chin and to help define your jawline. A neck lift can be performed alone or in conjunction with a facelift. I believe in tailoring each surgery to the needs of the patient. I never want you to have more surgery than is necessary.
The best candidate for a necklift is an individual whose neck does not match the age of their face. Many patients present to my office complaining that they have a turkey wattle, their neck looks too fat and undefined, they lost the distinct jawline of their youth, or they hate the loose skin and wrinkles. For some patients, the neck ages much faster than the face. For others, it is the opposite and they undergo a mini-facelift. Good candidates for a necklift are healthy individuals who do not have other medical conditions that may impair healing. It is essential that the patient is not smoking, as nicotine impairs wound healing.
Making Your Mark…The Incision
A necklift addresses the jawline and the neck via inconspicuously placed incisions behind the ear and around the earlobe. The extent of the procedure will determine the length of the incision. For surgeries requiring more advanced neck techniques, the incision is often extended into the hairline. When neck bands, called platysmal bands, are your main complaint, an additional incision is placed in the crease beneath the chin. Many patients already have a scar from childhood in this location. I will try to use this scar. Every effort is made for the incisions to be as inconspicuous as possible so that it is still possible to wear your hair in a ponytail. Through these incisions, the excess neck skin is repositioned and the platysma muscle is tightened. The skin is re-draped over the uplifted contours and the excess skin is trimmed.
The Internal Corset
When you pull your neck back in the mirror or in photographs, you are not only pulling up excess skin but repositioning your neck muscles or the platysma muscles. To maintain these changes, it is necessary to create an internal corset or platysmaplasty. I am able to create the corset through an incision under your chin and from the incisions around your ears. The platysmal muscles are brought together in the center and then elevated on the sides to create support for your necklift. The muscles are then partially cut to prevent future bands from forming.
To Lift or to Suck
The decision to have a necklift or to undergo liposuction is determined by the amount of excess skin and neck bands. A young patient with fullness under his/her chin will likely benefit from only submental (under the chin) liposuction. The liposuction will remove extra fat and the skin will contract. Often submental liposuction can be performed in the office under local anesthesia. Sometimes, I will use laser or ultrasound-based liposuction to enhance skin tightening post-operatively. When there is extra skin or the presence of neck bands, only surgery will be able to remove the extra skin and eliminate the bands.
Location and Anesthesia
A necklift may be performed in a hospital or an outpatient surgery center. I work closely with an anesthesiologist to make sure that you are monitored throughout the whole procedure. The anesthesia consists of local anesthetic and IV sedation. The procedure lasts for two hours.
Recovery time depends on the extent of the necklift and if any additional procedures are performed. Patients often find the operation less painful than they would expect and are taking only Tylenol for pain after a few days. During the first evening, one of our nurses will stay with you to make sure that you are comfortable and to monitor your blood pressure. You will have a bandage applying firm pressure to your neck to minimize swelling and bruising. A thin tube is present which will drain any excess blood or fluid that may collect under the skin. This is done to reduce the recovery time. I will visit you the following morning to check on you and remove your dressings and the thin tube. Stitches are removed in ten days. For patients who have traveled a long distance, I ask that you stay in the New York area for 10-14 days before flying home. You can engage in light exercise on day one and should be back to work in seven to ten days.
THREE MONTHS POST SURGERY
The results from a necklift are visible immediately but you will see that your neck continues to improve over the next six months as the swelling subsides. The results are dramatic and long-term. These results can be enhanced by sun protection and proper skin care. Non-surgical treatments can also be used to help maintain a youthful appearance after surgery.
Many patients ask, “How long will my necklift last?” One could argue that the changes from surgery will last forever. As you age, your neckline will always look better than it would have without surgery. But over the years, the tightness in your neck will soften.
A Picture is Worth a Million Words
A picture may be worth a million words but in the age of the internet, online photos can be viewed by billions of eyes. In respect of patient privacy, a before and after section was not created on our website. Several patients have agreed to allow their photos to be viewed by prospective patients in the office. You may request to view photos during your consultation. Some patients have also agreed to speak with prospective patients if you would like to learn more about the procedure from a patient’s perspective.
What is the first step?
If you are considering having a necklift, please call our office at (212) 600.4109 to arrange for a consultation. Our New York City practice accommodates out of town and international patients who need to travel in for surgery as well as those who are local to Manhattan.