Neck lift
A Surgical Neck Lift (also known as a lower rhytidectomy or platysmaplasty) is a powerful and long-lasting cosmetic solution designed to restore a firmer, more defined, and youthful contour to your neck and jaw.
Concerns like a “double chin”, neck bands, and a loose jawline can significantly impact your confidence. Sometimes this appearance is a family trait that people have seen in their parents. A tailored surgical necklift directly addresses these age-related changes, providing results that non-surgical treatments often cannot match.
A neck lift can address:
- Heavy jowls
- Wrinkles
- Excess skin and fat
- Platysmal folds
- Turkey neck
- Jawline contouring
The Goals of Neck Lift Surgery
1. Eliminate Persistent Submental Fat (Double Chin)
Submental fat, or a double chin, is a common concern that can be resistant to diet and exercise. The surgical approach ensures effective and permanent fat removal to enhance and sharpen your profile.
2. Resolve Sagging Jowls and Jawline Definition
Jowls form when the skin, fat, and deeper tissues of the lower face and upper neck become lax and descend, blurring the once-sharp angle of the jawline. They form the fatty, loose areas to the sides of the chin.
3. Tighten the loose platysma muscle
The ultimate goal of a surgical necklift is to create a sleek, well-contoured transition between the face and neck, delivering a sharper jawline and flat contour under the chin.
Neck lift surgical approaches
For younger people with Submental Fat (Double Chin):
Neck Liposuction is often a good option. It can remove excess fatty deposits from under the chin and along the jawline. For deeper fat or more comprehensive contouring, direct excision may also be performed. This is usually best in younger people with good skin quality and lots of elastin that can take up the emptied space without the need for skin removal.
Resolve Sagging Jowls and Jawline Definition
I find liposuction of the jowls at the time of a necklift is helpful to reduce the volume here followed by release of the mandibular ligaments which hold the front of the jowls tight to the bone and then the lift of the SMAS which helps to tighten the jawline. This is usually in conjunction with a lower face and neck lift procedure.
Tightening and lifting the neck
Here a Corset Platysmaplasty (tightening of the platysma muscle) is performed through the small incision under the chin. This muscle tightening pulls the deep tissues into a youthful position, smoothing vertical neck bands and providing internal support to define the neck-jaw angle. At the time of the Corset Platysmaplasty, the lower part of the muscle is released to address the platysmal bands that are often present in people who are 50 years or older.
Combining skin removal, liposuction, and muscle tightening yields the most pronounced and long-lasting jawline definition.
Isolated liposuction under the chin can yield great results in younger people. Sometimes in this group, open excision of the fatty tissue is needed and may be combined with platysmal tightening.
What about non-surgical Neck Lift techniques?
There are other options offered in New Zealand that you may have come across to reduce fat under the chin. There are injections that have been tried which try to melt the fat. I haven’t used these injections but I have seen a number of people who have tried this option where it hasn’t worked and was quite painful at the time.
For platysmal bands, botulinum toxin can be used to try to decrease their activity and prominence. I don’t offer this option as I don’t think it works well. My experience of these bands when operating is that they tend to be folds of muscle rather than tight spasms of muscle. The best way to treat a fold is to unfold it and the only way to achieve that is with open surgery.
From both my own experience and from overseas research, the open lower face and Neck Lift offers the most safe, reliable and cost-effective technique for neck and jawline rejuvenation for patients.
Usual post-operative course and management
Recovery and Results
• Downtime: Most patients can return to work and light social activities within 10 to 14 days, though swelling and bruising will gradually subside over several weeks.
• Activity: Strenuous activities and heavy lifting are typically restricted for 3 to 6 weeks. Between myself and the nursing staff, we will provide you with a post-operative care plan depending on the surgery undertaken.
• Longevity: The results of a surgical necklift are ‘forever’. The fat reduction will be permanent and even though gravity and time mean that the platysmal bands can slowly return, I see that people who have had a neck lift always look better overtime than if the surgery had not been done. People who seek a revision neck lift are often 10-15 years after the original surgery.
When should a neck lift be done? Am I better to wait until I am older?
These are common questions that I get asked by people interested in having a neck lift. The most common age for a Neck lift and Face Lift is mid-late 50’s to 60’s when the full effects of ageing are seen but also a time when people feel vital and youthful but their face may not reflect that vitality.
There are people younger than 45 who have early neck changes such as a double-chin who would benefit from a Neck Lift or sub-mental liposuction.
The cost of Neck Lift and Sub-Mental Liposuction
For Sub-Mental Liposuction alone, this will often take around one hour of surgical time and is best under a general anaesthetic (meaning going to sleep). The cost can be 12-15 thousand dollars.
For an Open Sub-Mental Fat Reduction with or without a Corset Platysmaplasty, this can take around 1.5 hours and would be 15-20 thousand dollars but there is some variability depending on the size of an individual’s neck.
A full Neck Lift is best combined with a Lower Face Lift using the Deep Plane Technique. Costs for that procedure can be found here.
FAQs: Potential problems that may arise and how they managed
1. Bleeding
Sometimes there can be a little bit of bleeding from the incision lines which usually stops with gentle pressure for up to three minutes. If the bleeding hasn’t stopped after three minutes please give us a call at the office for further advice.
2. Seroma
This is a problem when a small amount of fluid has collected underneath the skin. This is much less common in facelifts than in other surgeries and it simply needs a small needle drainage to fix the problem
3. Wound healing problems
Occasionally there can be small areas where the incision takes a little longer to heal. This can be normal especially behind the ear.
4. Facial nerve injury
This occurs rarely. This is where a nerve that supplies the motor function of the face can be affected by the surgery. The most commonly affected nerve is the Marginal Mandibular Nerve which runs underneath the jawline to supply the corner of the mouth. If this has been affected by the surgery it can look like the person has had a stroke. Often this is temporary but occasionally could be permanent. I personally haven’t had this problem in my practice for any facial surgery but I do hear from others that if it does occur it can be very distressing.
5. Asymmetries
Everyone has different aspects to their face and are different on each side. There will always be some subtle differences between each side and that is to be expected.
6. Neck relapse
Up to one in ten patients can have some relapse of the platysmal bands of the neck wrinkles following the surgery. This often becomes evident after three months following the surgery. In some patients a year after the surgery, they require another operation in order to re-address the neck bands.
7. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)
Occasionally following the surgery, you can get blood clots in your legs. This is a risk of any General Anaesthesia but it’s fortunately rare in facelift surgery. In order to minimise the chance of this we are careful to ensure patients have calf compression devices on during the operation which massage the lower legs and keep the blood flowing. Following the surgery we also encourage patients to mobilise early by walking around.
8. Numb earlobe
There is a sensory nerve that runs up to the ear lobe known as the Greater Auricular Nerve. Occasionally this can be affected by the surgery meaning that the sensation to the earlobe changes. More commonly for patients is that they notice the outer aspect of the cheeks is numb following the surgery. This is due to elevating the skin of the underlying tissue.
9. Scarring
Sometimes people make the scars that can stretch. I do my best to ensure there is no tension on the skin at the end of the procedure which means that getting a poor scar is less likely.
10. Temple lumpiness
After the surgery, many patients have fullness and bumpiness in the temple area just in front of the incision usually at eye level. This is common and will settle on its own over a period of 4-8 weeks.
The lumpiness is due to the big lift that you get from a deep plane procedure and is better to leave some lumps that settle than to make the incision unnecessarily longer.
11. Bruising
There is often bruising in the skin after a facelift. Sometimes the bruising doesn’t appear straight away but can take a few days. Most of it is usually gone by about 2 weeks after the surgery.
There are some people who have bruising that may last longer, almost like a little stain in the skin. This can sometimes take 6-8 weeks to finally go and can be frustrating as it just takes time. Some people use concealer to cover the area or others have used arnica to help resolve the bruising a little faster.
I hope you find these guides helpful in preparation for surgery and for your recovery. It will cover general details of surgery and the normal way that individual’s recover after facial surgery.