Understanding the Necklift

At the outer level of the neck are three main components that exhibit the signs of aging. These are the skin, a layer of fat, and the platysma muscle. Aging in the neck is manifest by loss of elasticity in the skin, wrinkling in the skin, and sagging in the platysma muscle, and changes is fat distribution.

Most patients initially complain of sagging bands in their neck. This aging is manifest by one or two sagging bands first starting above the Adams apple and eventually descending along the entire neckline. The bands that develop in the neck are due to the flaccid drooping of the platysma muscle.

The platysma is a paired broad thin muscle that runs from the collarbone to up above the jaw line and extends from the middle of the neck in the front to about the ear. The platysma is an interesting muscle in that it is not supported on any bone. Therefore, it just sits on the soft tissues of the lower face and neck. As these tissues start to age, they lose volume, loosen and descend. The platysma follows these structures and does the same.

This aging may also be accompanied by a change in the volume of fat above the platysma and deep below as well as the changes in the skin.

A necklift is designed to repair the aging changes isolated in the neck. It is almost always included in a modern facelift. Some facelift “factories” that specialize in your “lifestyle” may try and include it as an after charge to an old style facelift. The necklift is designed to isolate and correct the aging changes from the jaw line down. This is a very important point to understand because the jowl often has a facial component and a neck component. Patients often believe that a necklift will completely correct the jowl. However, the necklift is really designed to only correct the neck component of the jowl.

There are many different types of necklift incisions and procedures. Typically the operation uses a transverse incision under the chin for access to the front of the neck. It also uses an incision behind the ear for access to the backside of the neck. These limited incisions give the surgeon access to the neck from the jaw line down. The surgeon will use either liposuction to contour the fat or excise the fat directly. The muscle is lifted in the midline and the right and left sides are sutured together via a variety of techniques and then tightened in the back. The incision in the front is then closed and the skin is advanced in a posterior – behind the ear direction, to eliminate the loose skin.

For most patients who are correct candidates, the recovery involves very little discomfort and minimal swelling. Most patients are able to return to work within a week. For more information to see if the neck lift is right for you, please see your Plastic Surgeon.

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