Principles of Cosmetic Neck Lifts

Serving Chattanooga, Tennessee

ne of the most common complaints regarding the aging face is the loss of the youthful contour of the neck and jaw line. This contour change manifests as fatty deposition in the neck, sagging skin, and the absence of a crisp bony jaw line. The most powerful technique to combat these changes is a neck lift. The neck lift focuses on the anatomic changes that have occurred over time and restores neck architecture to a more youthful appearance. Neck lifts are often included in overall facial rejuvenation as a component of a facelift, but can stand alone in many patients. The key is an appropriate pre-operative consultation.

In order to understand how a neck lift works, it’s important to be acquainted with neck anatomy. Beneath the skin of the neck is a fatty layer which may be of variable thickness. Deep to the fat layer is a thin sheet of muscle which runs from the collar bones to the jaw. This muscle is called the platysma. Underneath the platysma are a bit more fat and the important nerves, blood vessels, and glands of the neck. The neck lift’s power as a reconstructive procedure lies in its ability to correct or tighten the platysma. How is it done? Through incisions beneath the chin and running just in front and behind the ears, the skin of the neck is elevated from the platysma. This affords the opportunity to remove some of the fat which is between these two structures.

With this step completed, the underlying platysma is visualized directly. Right beneath the chin, there may be a fat pad lying above the Adam’s apple. If this is the case, it can be removed. The platysma is then tightened much like one would lace together a corset. Stitches run from the chin all the way to the notch where the collar bones meet at the top of the breast bone and back again. The effect is commonly enhanced by "lifting" stitches in the muscle below the ear.

Often after the muscle portion of the procedure is completed, there is excess skin because the area of the neck is now smaller. This skin is removed through the incisions around the ears. Here, the scars are minimal and well concealed. Additionally, the length of even these scars is dependent upon the amount of skin to be removed. The smaller the skin removal is, the shorter the scar will be.

A sedation type anesthesia is utilized for neck lift in our practice. I don’t believe that this extent of correction can be accomplished safely and effectively with local anesthesia alone. Good general health is the key to patient selection, and smoking is forbidden for one month before and, hopefully, forever after aesthetic surgery. Preoperative computer imaging is helpful in communicating the expected result from neck lift. Photographs of prior patient results also help to keep expectations realistic.

Neck lift patients usually leave the operating room in a soft bulky head/neck dressing and a drain. They rest at home with their heads elevated for 24 hours and then return to my office for a wound check. The drain is removed and they are redressed similarly. Two or three days later they return again and a light removable dressing is placed. They may shower and wash their hair at this point. All sutures are out by day 10.

Neck lifts are remarkably effective because they address the specific anatomic distortions which have occurred over time. For more information on neck lifts and face lift surgery, contact us today.