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Necklift

The neck is made up of various structures including skin, a variable amount of fat and the underlying Platysma muscle. The variations in those structures, along with their respective relationships to the chin and other internal structures, gives the shape of the neck. For some unknown reason we have defined the beautiful neck as a long, well defined structure with a visible angle from its vertical portion to its horizontal section. In some individuals because of genetic differences, or aging that visual appearance does not meet an individuals desires. Surgical correction may help ameliorate those relationships.

Dr Yousif has been studying the aging neck over the last 8 years. He and his associates recently presented a portion of their results on the anatomy of the neck and its relationships at the prestigious Association of Plastic Surgeon meeting. From those studies, Dr Yousif has devised new procedures to improve the results of surgery while at the same time limiting the surgical scars.

In youth there are typically two issues that may need correction. One is the excess deposition of fat in the upper portion of the neck obscuring the desired defined angle and the other is the platysma. This muscular laxity is often over looked in younger patients that are looking for a more defined neck therefore limiting the final results of surgery and in older patients the ability to create a well defined neck that last has been difficult.

There different aspects to the neck that at times may lead someone to want to change its visual presentation. There may be, even in youth, excess beneath the chin. This is usually a genetic deposition of fat in the area above or even below the muscle. The aging neck has many components. With time the soft tissue weakens and there maybe soft tissue descent giving visible excess beneath the chin. Different procedures may be performed to enhance the appearance of the neck by removing excess skin (cervicoplasty), altering neck muscles (platysmaplasty), or removing excess fat (liposuction.)

New Techniques

Dr Yousif is in the process of publishing new techniques for contouring of the neck. These techniques are a significant improvement over older procedures and allow a youthful natural contouring of the neck with long term results. In some patients these can be done only through small incisions beneath the chin. This new "limited scar neck lift" can have dramatic results with only a small scar beneath the chin.

The Aging of the Neck

The aging neck is a combination of factors that may differ in each patient. Understanding the anatomy may help to understand the aging process. The neck is seen in two sections the lower vertical part and the upper horizontal portion. The horizontal portion is really the mandible or jaw portion of the neck.
Within the neck there are multiple structures. Beneath the skin there is a variable layer of fat and beneath that there is a thin muscle that covers most of the neck called the platysma. This is a vestigial muscle that that is present on both sides of the neck as individual muscles. You can see the outline of this muscle if you tighten the neck as though you are angry and showing your lower teeth. This muscle is not truly functional but does pull down the lower lips slightly. Beneath the platysma there can be additional fat and another layer of deep well supported muscles.
The skin, platysma and underlying fat all can contribute in the visible aging of the neck. The youthful, attractive neck is a neck that shows a well-defined distinction between the horizontal and vertical portions. That is called the cervico-mental angle. Several factors of aging can work to hide that distinction. An increase in weight or fat in the neck may hide that cervico-mental angle. The platysma with age and time can push forward and the front borders may become visible as anterior lines. The skin can weaken with time and become looser with age. Although the length of the jaw line can effect the look of the neck it is not truly part of the aging process. There is also a gland beneath the lateral part of the jaw (submandibular gland) that can at times drop with age and become visible as fullness in the lateral part of the jaw.

Treatment Options

There are a number of procedures available to enhance the appearance of the neck. They range from very minimal in-office treatments with no down time, to more invasive procedures requiring anesthesia and time off for recovery.

Botox Injections

The vertical bands that extend from under the chin to the base of the neck are caused by the neck muscle called the platysma. Botox can be injected into the muscle to temporarily reduce the appearance of these bands. This is a simple in office procedure that requires no anesthesia and allows you to get right back to your normal activities.

Neck liposuction for fat removal

Removal of fat in the neck may or may not be part of the treatment of the aging neck. It can be seen in younger individuals as well as older patients. In younger individuals removal of fat alone to help define the neck may be helpful. In older individuals the laxity of skin may not allow appropriate tightening with liposuction alone to re-define the neck. So liposuction alone is usually reserved for younger patients. This is usually done through small incisions under local anesthetic with or without some sedation.
Recovery is usually just a few days but some support of the skin may be required for 2-3 weeks. This is usually done with some type of elastic garment worn for a portion of time during the day and for a bit longer at night.

Natural Looking Designed To You.

Although each person's results will differ, before and after photos are good examples of potential changes. They should be used not only as a comparison of techniques and surgeons, but are good starting points for evaluation, comparison and discussion with your surgeon. Please note that these are post surgical photos that are not suitable for all audiences. Viewers should be 18 or older to view the gallery images.

See More Before and After Photos >

Anesthesia and Surgery Facility

In most instances the neck lift is done under general anesthesia but depending on the patient’s desires it may be done under local anesthesia with some type of sedation.

Side Effects

There is expected temporary discomfort, swelling, and bruising. A temporary feeling of tightness may also be possible.

Smoking

Smoking may be one of the most important factors that increase the risk to facial surgical complications. If you are a smoker, you will need stop smoking for least two weeks before the surgery and two weeks after. You must not smoke for this time period to ensure proper healing, because cutting down is not adequate. Nicotine gum and nicotine skin patches can lead to the same healing problems caused by smoking.

Other Medications:

Some medications that increase bleeding times may add to the risk of bleeding during any surgery but especially during facial surgery. It is important to discuss all medications that you are taking both prescription and over the counter.

Risks

These include infection, pooling of blood beneath the skin (hematoma), and loss of sensation.

Recovery

Bruising is usually minimal but may last 2-3 weeks. The patient is usually asked to limit motion of the neck over the same period of time. The neck may feel numb for several months.

Duration of Results

Results may be enjoyed for 7 to 10 years.