Several variables will determine the ideal neck lift procedure. Nevertheless, it remains imperative to place the scars behind the ears (specifically within the natural skin folds) and/or beneath the chin to hide the surgical stigmata.
- Standard technique. In general, it aims to correct the turkey wattle appearance by making around 3 cm incision beneath the chin (and possibly behind the ear if there is some excess skin as well). The idea is to access the muscle called platysma, which is responsible for the sagging neck.
Because the goal is to achieve a smooth right angle under the chin, many patients will need their muscles to be sutured across the midline in what doctors refer to as a “corset approach.”
But for a few patients, cutting or removing some muscle might be indicated to achieve good results from neck lift.
- Skin lift. To remove the excess skin, incisions behind the ears are also needed. Nevertheless, it remains important to tighten and reposition the underlying structure such as the deep muscle and superficial fat to achieve long-lasting results and prevent tension on the wound, which is known to cause poor scarring.
In general, a skin-only lift is not practical because without reshaping the deeper structures the skin will only relax and sag over time.
- As a stand-alone procedure it is rarely performed in older patients because they generally have poor skin elasticity. To achieve good contour, platysma muscle tightening and skin excision are commonly used as well.
Through a small incision beneath the chin (and sometimes behind the ears), doctors are able to correct the double chin appearance. However, it is imperative to leave some fat to cover and hide the underlying muscle.
With over-liposuction, the muscle might show, leading to unnatural results and/or more aged appearance. For this reason, most surgeons will only remove a conservative amount of fat to anticipate further tissue atrophy (or volume loss) caused by aging.
A good number of neck lift patients can benefit from facelift that is performed simultaneously with their surgery. The idea is to achieve a smooth transition between the mid face and neck area, leading to a more rejuvenated countenance.
Other common ancillary procedures include Botox injection, dermal fillers, fat grafting, rhinoplasty (nose job), and chin augmentation via implants.