when is a surgical neck lift needed the neck is an area
particularly prone to aging changes specifically the neck skin is thinner
than facial skin and it has fewer oil and sweat glands than the face
people concerned about the appearance of their aging neck
often ask me when a surgical neck lift would be appropriate
i'll discuss the different ways aging affects the neck
different treatments to improve the neck appearance
and when a surgical neck lift is worth considering
I'm Dr Amiya Prasad I'm a Board-certified cosmetic
surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon i've been in practice in New York City and
Long Island for over 25 years I routinely perform surgical neck lifts
often in combination with facelift surgery such as
deep plane facelift i also perform procedures for
neck enhancement such as platysmaplasty for prominent neck bands as well as
minimally invasive neck procedures such as suture
suspension in addition we also do non-surgical neck
treatments to improve skin quality and volume in the neck area
generally surgical neck lifting is for sagging skin in the neck
area there are several neck procedures that can be done to improve
neck sagging for people with less advanced sagging neck skin
prior to any neck procedure i perform an examination of the neck and specifically
look at things such as neck skin thickness the
absence or presence of fat below the skin the
amount of excess neck skin if any the
elasticity of the neck skin and the presence and
absence of platysmal bands i also look at facial volume loss
particularly in the areas of the cheekbones
chin jawline and jaw angle if the neck skin has thinned and the
skin quality is reduced but there isn't a significant amount of
sagging surgical neck lift is generally not
indicated what can be done is to improve the
quality and thickness of the neck skin with non-surgical procedures a treatment
to improve skin thickness and quality by stimulating the body to generate
collagen is the application of platelet-rich
plasma or PRP platelet-rich plasma is made up of the
concentration of wound healing and growth factors
that exist naturally in your blood we prepare PRP
with a blood draw similar to what you would have done in a routine lab test
PRP is prepared by spinning the blood in a centrifuge to
concentrate the platelets into a yellow serum
when PRP is delivered into the neck skin these wound healing and growth factors
can help thicken the skin and improve skin
quality texture and appearance for the neck i often combine PRP with
hyaluronic acid and use a device which creates micro channels into the skin
we call this procedure Skin Boosting unlike with microneedling
Skin Boosting there's no bleeding and requires no
downtime skin laxity with excess fat can also be treated not surgically
for example we use a long pulsed 1064 YAG laser
to deliver heat in a way that results in fat reduction
and skin tightening simultaneously this procedure takes from 10 to 30
minutes to do and there is no downtime patients come for sessions depending on
their individual situation people who come for neck enhancement are
often unaware of how facial aging can affect the neck
appearance one of the first signs of facial aging
before their significant skin laxity and
descent is facial volume loss this is defined as loss of volume
affecting the bone muscle fat and soft tissue in particular
volume loss in the chin area can cause a loss
of forward projection which can cause the appearance of sagging
neck skin an important concept to understand
is that the jawline cheekbone and chin are all pillars which support the face
and neck skin this means that enhancing the volume of
these three strategic areas can improve the appearance of the neck
particularly below the chin this bone volume enhancement is called
Structural Volumizing which is performed using
long-lasting hyaluronic acid fillers with the
technique derived from facial implant surgery this procedure is
performed routinely in an exam room with local anesthesia and typically
without any bruising situations where there is
laxity that is too much to treat with laser-based
tissue heating can be treated with a minimally invasive
surgical procedure called suture suspension neck lift it's
important to distinguish suture suspension from a thread lift
a thread lift is the passing of barbed sutures in an attempt to build
collagen in the skin to create a tightening
effect which is minimal at best when i perform a suture
suspension procedure i'm using some of the same sutures i
would employ in an open surgical neck lift and engage the
sagging neck skin and anchor the sagging skin to a deeper
bone level a lot of my patients come in concerned
about the appearance of their neck bands also known as platysmal bands
the platysma muscle is a long vertical muscle
which originates from the clavicle and extends up the neck
when you're younger the platysma muscle is flat and smooth
aging changes the muscle tone and it appears to
separate into what is seen as platysmal bands
if there is little to no loosening of the overlying skin
then treatment can be done with a neurotoxin like
Botox or Jeuveau to relax the muscles so the bands are less prominent
particularly with movement if the platysmal bands are too loose
then i can perform a surgical procedure called a
platysmaplasty to improve the neck angle a platysmaplasty
can be performed as a standalone procedure
or with a more extensive neck lifting procedure
when there is significant neck laxity a surgical neck lift can be the best
option for this particular issue a surgical neck lift can be performed as a
separate procedure or in combination with the facelift
i routinely discussed in consultation that the neck
does not age in isolation but rather some of the skin
under the chin is caused by sagging of the facial skin downward
the patient will often recognize that when they lift
their cheeks upward and the skin below their chin
looks much better the purpose of a face-up surgery is to restore the
anatomy of the cheeks jawline and neck which have descended
due to age-related tissue laxity a typical facelift incision is placed
strategically in front of and behind the ear when a neck lift is performed at the
same time the incision is extended further behind the ear in order to be
able to redrape the neck skin and remove any excess skin that overlaps
it is sometimes confusing for people to understand which type
of facelift is best for them due to the wide use of proprietary names
regardless of the branding of different facelifts there are some
basic principles that apply when a surgeon is
determining the optimal strategy for you basically the type of facelift you need
depends on the degree of facial skin muscle and soft tissue
laxity a mini lift for example or short scar
facelift has a shorter incision and is typically
performed when there is minimal skin laxity characteristically
seen in people who are in their 50s or early 60s for people in their
later 60s and older a more extensive facelift like a deep
plane facelift and neck lift can be necessary in order to address
more extensive cheek descent and excessive neck skin
since a large proportion of facelift and neck lift surgery is performed under
general anesthesia patients are often concerned about
prolonged recovery very often people coming for a facelift
surgery consultation are familiar with someone who they know
who underwent surgery and it was their
experience was characterized by significant bruising swelling and weeks
of recovery in my practice i perform face and neck
lift surgery under local anesthesia with LITE IV sedation
so our patients are comfortable in a twilight state of consciousness
breathing on their own throughout the surgery
this is to contrast with general anesthesia where
patients are temporarily paralyzed and need to breathe
with the assistance of a ventilator patients under general anesthesia often
have to stay overnight at a facility after surgery
with skilled nursing assistants for monitoring
and wound care such as needed when there are drains
in our practice when i perform these procedures using
local anesthesia and light iv sedation patients go home afterwards and with the
basic facial dressing generally my patients
return to work about a week to two weeks after surgery
depending on the type of facelift we performed surgical neck
lifts are usually indicated for advanced aging when neck skin muscle and
soft tissue laxity is too extensive to address with more
conservative procedures neck rejuvenation can be effectively
performed with minimally invasive procedures ranging
from the application of platelet-rich plasma long-pulsed
laser neurotoxins such as Jeuveau and suture suspension these procedures
can also be combined for more optimal minimally
invasive neck rejuvenation the marketplace is saturated by medical
retailers pedaling procedures and devices which
mostly over promise and under deliver on any given day i see patients who went
from one place to another having different
brand name non-surgical miracle neck tightening devices procedures
only to be disappointed by their results and frequently distressed because they
feel that their neck skin is actually even worse than before there's
never been a greater need for people considering neck
rejuvenation to find an unbiased cosmetic doctor who can
help them develop a neck rejuvenation strategy
i hope you found this information helpful thank you for your question
you