Many people don’t realize that a neck lift can be done as an isolated cosmetic surgical procedure. As the neck is often the culprit that gives away ones age, it is often one of the first areas that patients see a plastic surgeon for rejuvenation.
As Part of a Facelift
A neck lift is actually the lower half of a standard facelift. While some surgeons routinely perform a less involved facelift, which skips all or much of the neck portion of the surgery, a well-done modern day facelift generally includes an extensive neck procedure so that the finished product is a balanced rejuvenated result.
To approach the neck, incisions are placed in three areas. The first is a relatively short one just under the chin where the majority of the work is done. This tends to be hidden very nicely and tends to heal as a very fine line. The other two are symmetrically placed starting just behind the earlobes, running vertically in the creases behind the ears and then turning backwards either into the scalp or along the hairline in that area depending on how much skin is to be removed.
The old-fashioned neck lift done at the same time as a facelift that was done decades ago consisted of taking out some fat and pulling the skin tight. This type of lift gave more of a wind-swept look and an operated look that did not last very long. Eventually it was determined that the muscle (platysma) was the cause of vertical bands in an aging neck and re-suspension of this muscle (platysmaplasty) is probably the most important part of a neck lift to give a lasting and natural looking result. More fat removal and less pulling of the skin allows for the best appearance.
The platysma is a broad flat muscle that runs vertically on both sides of the neck. It is the loosening of the medial aspect of the muscle that causes the vertical bands along the central aspect of the neck that most patients attribute to excess skin. In a modern day facelift and a good neck lift, these muscles are sutured together in the midline of the neck to form a muscle sling, which is then pulled up laterally to tighten the neck and create a youthful contour.
Excess neck fat can be removed as an isolated procedure with liposuction or at the time of a neck lift. The former may allow for adequate correction of a full neck that has good muscle structure and elastic skin. With a neck lift, fat is often removed both with liposuction at the beginning of the surgery and by direct excision prior to completion of the procedure.
Patients are seen on the first post-operative day at which time the dressing is changed and the drain may be removed depending on the output. All sutures are removed within a week and normal activities can be resumed in 10-14 days with more strenuous exercise in three weeks.