Like the eye area, the neck may show signs of aging prematurely and is therefore a common concern for patients. A variety of neck problems may exist: 1) too much fat, which leads to a double or triple chin; 2) excess skin below the chin, commonly called a “turkey waddle”; 3) long vertical lines that extend from the chin to the collarbone (called platysma bands); or 4) a combination of all the above.
For people with excess fat below the chin and good skin elasticity, liposuction may be sufficient to get rid of a double or triple chin. Liposuction alone works especially well in younger patients without much skin excess or laxity. For those who already have loose skin, liposuction will remove the fatty deposits but can accentuate the skin laxity.
A common complaint of patients with loose neck skin is that this “turkey waddle” impairs the ability to wear collared shirts because the extra skin hangs over the collar. In these cases, a neck lift is the best way to remove the loose skin and recreate the angle in the area under the chin. This procedure rejuvenates the neck by tightening the platysma muscles, which are visible as vertical bands running down the neck. Though a neck lift can be done by itself, it is usually incorporated into a facelift and may also be combined with neck liposuction.
“Necklace lines,” which are horizontal creases visible across the neck, are bothersome to some people. These lines can be treated effectively with Botox to relax the platysma muscles that contribute to formation of these creases. Other treatments for hiding necklace lines include tissue fillers, such as fat or Restylane.
The Surgery
A necklift is done through a small incision made under the chin and may also require incisions behind the ears that extend into the lower scalp. Through these incisions, the skin is separated from the fat and muscle below so these underlying tissues can be tightened and secured into a new position to improve the contour of the neck and get rid of the visible vertical bands that run down the neck. The skin is lifted upward and back, then the excess trimmed off. The stitches used to secure the incisions are typically removed after 5 to 7 days.
Liposuction may be the only procedure needed for neck rejuvenation or it may be combined with a neck lift. In liposuction, one or more small incisions (less than a half-inch in length) are made in an inconspicuous location behind the earlobe and/or under the chin. The first step is to inject (infuse) a specified amount of fluids that is roughly equal to the amount of fat to be removed. This fluid consists of saline (salt-water) solution that contains epinephrine. The saline plumps up the fatty tissue, and the epinephrine constricts the blood vessels to minimize bleeding. A slim hollow tube, called a cannula, is then inserted through the incision and moved back and forth through the tissue to break up the fat cells, which are then suctioned out, along with the infused fluids.
What To Expect After Neck Rejuvenation
For a neck lift or neck liposuction, the area is wrapped loosely in bandages after surgery to minimize bruising and swelling, but these are removed the following day, after which you may shower and wash your hair. If you had neck liposuction, small amounts of fluids may drain from the small incisions. Although your neck will be bruised and puffy at first, you’ll look much better in a week or so. If you need it, special camouflage makeup can mask most bruising that remains.
Your head should remain elevated and as still as possible for a couple of days after surgery to reduce swelling. Once you’re up and about, take it easy for the first week after surgery. Your surgeon will give you specific guidelines for gradually resuming normal activities.
There usually isn’t significant discomfort after a neck procedure, but your surgeon will prescribe pain medication in case it’s needed. Most swelling will be gone in about 3 weeks, but the final results of neck re-contouring may not be visible for several months. The scars from the surgery are well hidden and will fade over time. Some numbness of the skin is quite normal, but it will disappear in 3 to 6 months.
Length Of Surgery
Liposuction of the neck takes about 1 hour, and a neck lift takes 3 to 4 hours.
Anesthesia
Usually general
In/Outpatient
Neck liposuction is outpatient. A neck lift is usually followed by 1 night in the hospital.
Side Effects
Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men who have a neck lift, permanent need to shave behind ears, where beard-growing skin is repositioned.
Risks
Bleeding, infection, poor healing (excessive scarring), injury to the nerves that control facial muscles or sensation (usually temporary but may be permanent).
Recovery
Back to work: 4-7 days for liposuction, 10-14 days for a neck lift.
More strenuous activity: 1 to 2 weeks or more.
Bruising: 1 to 2 weeks. Limit sun exposure for several months after a neck lift.
Duration of Results
Usually 7 to 10 years, less if you gain or lose a large amount of weight.
