As people age, decreasing skin elasticity can cause problems. Sagging neck skin and double chins cause self-consciousness, embarrassment, and even social anxiety. While many people suffer from loose skin across the face and neck as a whole, if it’s simply the appearance of your neck that bothers you and you’re fine with how the rest of your face looks, you might consider a neck lift, or platysmaplasty. In some cases, liposuction to permanently remove fatty tissue in the area might also be appropriate either alone or in conjunction with a neck lift in order to tighten the area.
Types of Neck Lifts
Generally, Dr. Bentkover performs two types of neck lifts. A submental platysmaplasty is a mini lift of the neck just under the chin, also called a submental triangle. A full neck lift is a much more extensive procedure, which involves the tightening and removal of excess skin on the neck, as well as the tightening of the neck and chin muscles.
Suitable for younger patients with less intensive sagging, the submental neck lift is a subtle yet effective “mini lift” that uses a very small 1-1.5 inch incision hidden in the crease just under the chin and does not remove any skin. By tightening the muscles in the area, it creates a smoother, more youthful look throughout the neck. The technique is frequently combined with liposuction or occasionally a chin implant to smooth the neck and jawline. Submental platysmaplasty is also often paired with other procedures, including blepharoplasty (eyelid surgery) for more comprehensive anti-aging. This form of the neck lift is very popular with patients in their 30s, but over the age of 45 it becomes increasingly likely that the neck skin will not tighten down sufficiently without removal of some skin.
Traditional Neck Lift
For older patients, or those who have extra neck skin due to weight loss or premature aging, a traditional neck lift combines the submental platysmaplasty with tightening the skin of the entire neck through an incision hidden in the creases surrounding the ear. This allows the skin and platysma muscle to be pulled parallel to the horizontal creases in the neck. The skin is then trimmed as needed, resulting in a tight, smooth, and youthful contour. This procedure is also frequently combined with liposuction to further sculpt the neck.
Candidates for Neck Lift Surgery
Good candidates for a neck lift include people who does not need a full face lift but are bothered by excess fullness under the chin, a double chin, or sagging skin throughout the neck. For a professional evaluation of whether this or other procedures will meet your needs, we recommend a thorough consultation with Dr. Bentkover.
During your consultation, Dr. Bentkover will carefully evaluate your neck and discuss with you how best to achieve your goals. In addition to examining your neck to check for things like skin thickness and elasticity, he’ll also take digital photos of you so that he can simulate changes in your appearance with our imaging software to give you an idea of the realistic outcomes of surgery. After your consultation, he’ll be able to recommend the type of procedure that will help you achieve your goals. If he believes you need a full face lift rather than a neck lift, he’ll be able to tell you so during this meeting. He’ll also be able to tell you which type of neck lift might be best for your situation.
Once you’ve settled on the right procedure or combination of procedures for you, our staff will provide thorough instructions on pre-surgery preparations to improve healing and reduce risks of bleeding and infection. If you’re a smoker, you’ll need to quit for at least two weeks before and after surgery. Certain supplements and over-the-counter drugs must be avoided for a few weeks before surgical procedures, and our staff will provide you with specific restrictions. Patients may also be prescribed antibiotics to help prevent any infections.
Since both types of neck lift are performed under general anesthesia or using an intravenous sedative with local anesthesia, we perform these procedures in the Same Day Surgery Unit of Saint Vincent Hospital at the Worcester Medical Center. The procedure may vary depending on whether you’re having another procedure such as a blepharoplasty, forehead lift, facial augmentation, or liposuction.
The neck lift procedure itself begins with the incisions. For a submental platysmaplasty, Dr. Bentkover will make a small incision under your chin where it meets the neck. For a full neck lift, he’ll also make small incisions in the creases around your ears. Once the incisions are made, he’ll place sutures to tighten the underlying muscles. If it’s a full neck lift, he’ll also tighten the skin and trim off the excess before closing the stitches. If liposuction is to be performed at the same time, Dr. Bentkover will make a tiny incision just under your chin. Using the incision for access, he’ll use a suction tube called a cannula to remove excess fat under the skin to tighten the whole area. Once the procedure is complete, dressings will be applied, and you’ll be able to have someone take you home once Dr. Bentkover feels it is safe, typically within a few hours of the procedure. A submental platysmaplasty takes about 30-45 minutes to complete, with a full neck lift and any other procedures adding time to the overall surgery.
After surgery, your neck will be wrapped to support the tissues and help them to heal in the correct position. The wrap and stitches will be removed at a follow-up appointment a few days after surgery. Pain is typically moderate and can be controlled fully with prescribed medications. Some bruising and swelling can be expected, but it will clear up within 7-14 days. Most patients are able to go back to work within 10 days, although resuming more intense activities such as aerobic exercise will need to wait until you get approval at a follow-up appointment 2-4 weeks after the surgery.
If you had liposuction, you can expect somewhat increased swelling and bruising in the area. You’ll also need to wear special garments to apply pressure throughout the initial healing process.
The neck lift is a safe procedure, and complications are rare. Like any operation, though, bleeding and infection are possible. There is also a small chance of nerve injury, skin discoloration, or persistent numbness. Complications with healing is more likely for smokers, diabetics, and patients with a history of radiation or autoimmune diseases.
For patients who have had a short chin their entire life, the distance from the chin to the voice box is shortened. As the skin in the area sags with age, the short jawline worsens the look. Although a neck lift can make you look better by tightening the area under your chin, a chin implant will actually lengthen the distance from the voice box to the chin, significantly improving the aesthetic outcome of the procedure.
In general, liposuction is a tool for sculpting, not a technique for weight loss. For patients who have a small amount of accumulated fat that simply worsens the look of sagging neck skin, liposuction can help smooth the area a great deal. For those with a more significant amount of fat, though, liposuction will not be enough to streamline the region.
Dr. Bentkover specializes in creating a natural appearance that will be pleasing to you while avoiding an operated or overly “pulled” look. By using fat removal and muscle tightening in addition to skin removal during a neck lift, he is generally able to achieve a natural-looking result.
The incisions from a neck lift are hidden under your chin and sometimes in the creases near the ear. The scars may be red and slightly raised for the first 8-12 weeks, but they’ll mature with time so that in 6-12 months they’ll be flat, soft, and the same color as the rest of your skin. Most women are able to wear their hair up in a few months without worrying about unsightly incisions.
Results will be recognizable almost immediately after the wrappings come off, but you may not be able to fully appreciate the final result for a few months, since it takes some time for the swelling to subside completely. Most patients find that their results improve gradually for up to a full year after the surgery and are quite pleased with their new and more youthful appearance.