Not Loving Your Neck?

We’ve all heard plenty about facelifts – and with good reason! They are incredibly powerful procedures for people that are looking for global facial rejuvenation. Did you know, though, that you could have a procedure to rejuvenate your neck alone if your face is doing just fine? A necklift focuses specifically on the neck and lower jawline. With age, the youthful face’s oval or heart-shape changes due to loss of volume in the facial tissues and descent of those tissues on the underlying facial skeleton. Isolated neck contouring is often performed in individuals after weight loss as well, as the chin and neck often have excess skin left behind after fat is lost in these regions. The lady in the photo above is shown before and 48 hours after an isolated extended necklift (you can still see some bruising and the sutures in place in front of her earlobe - the resulting scar fades to a point that it is very difficult to see at all).

A rectangular or triangular facial contour evoking age is the result, highlighted by the appearance of jowls on either side of the chin. Skin and muscle laxity also develop in the neck. If the muscles in the neck (the “platysma” muscles) separate from one another in the midline, vertical bands can result. As the pattern of aging is highly individualized, the exact neck lift technique used will be chosen on the basis of the patient’s anatomy. The majority of patients receiving a neck lift are in their fifties and sixties. However, everyone ages in a unique pattern that follows an individual pace. Therefore, many people opt for a neck lift before or after this age interval.

The necklift involves incisions that are well hidden behind the ears and in the crease behind the chin. In an extended neck lift, the incision is brought just in front of the ear lobe (and hidden in a skin crease) to allow access for jowl correction. These incisions are then used to reposition the foundational tissues of the neck, a series of maneuvers customized for each patient and often including a platysmaplasty. A platysmaplasty is performed to sew the two edges of the platysma muscle together in the front of the neck to eliminate the telltale vertical banding that they can cause. Liposuction is often used to achieve a refined jawline. Excess skin is then removed and the remaining skin is redraped over the rejuvenated soft tissue foundation.

It is important to remember that the face and neck are separate aesthetic units, and they age and mature at separate rates. Therefore, the neck may benefit from rejuvenation before the face, and the isolated necklift is a very worthwhile option in properly selected patients.

I hope this was helpful, and I invite you to join the conversation in our Facebook group at


Office of Darren M. Smith, MD

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