Neck Lift
Age: 39 Neck Lift
This male patient desired improvement in his neck area. He says a weak chin runs in his family. On examination he has a relatively weak chin and a significant amount of fat about his neck. He says that no matter how much weight he loses he still seems to always have a full neck.
He is seen here after an anterior neck lift that included liposuction of his cheeks and jowls and neck (75cc fat removal). This means an improvement of the neck obtained by manipulating the fat and muscle through an incision below the chin. This hides very well. These photographs are taken four weeks after his surgery.
We decided not to place a chin implant because I felt that it would be possible to obtain much definition of his neck without it. We could also always put one in down the line if he felt that it was necessary. A chin implant is ideal in many cases but none better than those who have a very weak chin bone. It’s a fantastic way to add fullness and balance to the lower face (harmony). The implants that I generally use are the non silicone variety as they stay where I put them and provide for impressive outcomes.
A “neck lift” can mean many different things to different people and surgeons. I have found that with a combination of liposuction and an incision beneath the chin that I can accomplish a lot in those patients who still have relatively good skin. Although no skin is actually removed, the skin retracts well in the majority of cases. Older folks and those with loose skin generally will need a procedure that also removes skin. The muscles in the anterior part of the neck are usually tightened as well. The benefit of an open approach to the anterior neck is that it’s possible for the surgeon to look beneath the muscle for a fat pocket beneath the muscle. In many cases the reduction of some of this fat can enhance the results tremendously. Liposuction alone does not remove this tougher, fibrous fat and it is very difficult to determine which fat is where without looking.
A chin implant is quite powerful. When used in the right patient the benefit is very gratifying. Problems associated with chin implants include infection and rotation of the implant as well as other issues. In the best of hands, however, it is a very reliable procedure. In some cases it takes patients time to get used to the new look when an implant is used. Too large of an implant in women can make them look masculine. Chin implants are often used at the time of a rhinoplasty (nose job) to enhance balance and harmony of the facial features.
Age: 35 Neck Lift
This young woman says she always had had fullness of her neck no matter what her weight is. She had good skin with fullness in the anterior part of the neck. There was no evidence of banding of the muscles and her submandibular glands were of normal size.
She is seen here four months after a neck liposuction performed from two tiny incisions beneath the chin. I removed about 45 cc’s of fat. This was performed with IV sedation. Note the obvious improvement in the contour of her neck. There is an improved neck angle and the submental (area beneath the chin) is much flatter than it was before.
Younger patients are more likely candidates for liposuction alone of the neck because they have better quality skin. Senior folks, or those with poor skin often benefit from an anterior neck lift with the incision beneath the chin and greater work on the neck muscle and skin. Incisions behind and around the ears is needed in those who have very poor skin that won’t retract well with an approach from under the chin alone.
Oftentimes it is important to make a small incision under the chin to look for fat that is beneath the muscle that can’t be removed with liposuction alone-if there is a fair amount of fat here the benefit can be enormous. It’s impossible to tell on exam alone where the fat is.
We used sedation in this case because of patient preference. Most people enjoy the benefit of anesthesia to make their experience more comfortable and less stressful. It takes up to a year for the skin to soften after a typical neck lift/liposuction. This is a very rewarding procedure for patients because it makes them look much younger especially when they see themselves in photographs taken from the side view.
Age: 38 Anterior Neck Lift
This is a female patient who is 145 pounds. She was interested in what could be done for her neck. She says it’s “full” and poorly defined. She is seen here after an anterior neck lift. This typically involves an incision in the crease beneath the chin, liposuction or direct removal of fat on the skin flap and reduction of fat beneath the muscle of the anterior neck. There is also wide skin undermining to allow a redistribution of the skin during the healing phase. You can clearly see the dramatic improvement in the neck and in her face in general. She looks thinner and more youthful. A full neck lift involves incisions behind the ear and skin removal. This is best for older patients or younger ones that have particularly poor, inelastic skin. It’s impressive the improvement that can be obtained from the anterior neck lift procedure that does not involve skin removal. The fat is reduced and the muscle is tightened only. The recovery is shorter than a full neck lift. This procedure is very popular with my patients.
Age: 49 Endoscopic Brow Lift and Neck Lift
This woman was interested in facial rejuvenation options. We discussed all alternatives, including a full face and neck lift. We elected for a brow lift and blepharoplasty as well as liposuction of her neck and lower face without any lifting procedures (I felt we could obtain an impressive result with smaller procedures). She is seen here five months after her plastic surgery. It is important to note that she has lost 30 pounds with the help of weight watchers. The surgery that we performed provided the incentive for her to lose the weight.
The important take home point is that weight loss alone can have a TREMENDOUS impact on your appearance. Look at the details of the photos including the size of her neck and the contour of her lower face. If you need to lose weight I would do this before plastic surgery. It’s unfortunate though that many patients can’t lose the weight without the help of plastic surgery but this is not without the risk of continued weight gain after your plastic surgery investment. This is why it is so important that your surgeon has the experience and judgment as to when to turn a patient away from surgery if he/she feels the outcome will not be in the patients best interest. This patient could have easily gained weight after this liposuction in which case the fat would have appeared unnatural in its distribution.
Age: 51 Neck Lift
This female patient is 5’1″ and 120 pounds. She desired improvement of her neck. I elected to perform an anterior neck lift procedure (an incision beneath the chin with wide undermining of the skin, tightening of the muscles and fat removal as needed–NO skin is removed). She is seen here at five months after the procedure. Note the improvement in the overall countour, a flatter area beneath her chin and a crisp neck angle. She has lost 10 pounds which has contributed significantly to her beautiful result.
