A neck lift improves sagging neck skin, loose neck muscles, and excess fatty deposits in the neck and under the chin. As with most plastic surgery procedures, there is no one standard neck lift procedure that suits the needs of all patients and the procedure must be customized to specific anatomy of the patient.
Before deciding what type of neck lift you need it is important to understand how the neck ages and what are some of the main features of an aging neck that can be improved with surgery. Sagging neck skin, a double chin, or a turkey neck each have different solutions and experienced plastic surgeons will have a number of neck lift options available to customize to the specific needs of each patient.
Neck lift by Sam Naficy, MD. * Individual results may vary.
There are multiple components that contribute to aging of the neck which must be considered in deciding the optimal neck lift option. The main components to consider for neck lift surgery include the following:
- Amount and location of excess neck fat
- Strength and projection of the chin
- Degree of fullness of muscles under the chin (digastric muscles)
- Degree of laxity and banding of neck muscles (platysma muscle)
- Presence of enlarged neck glands (submandibular glands)
- Degree of laxity of neck skin
- The quality of neck skin
Neck Lift Photo Gallery
You may wish to browse through the gallery of representative before and after neck lift pictures. Click on any of the thumbnails to enter the slide show. All procedures were performed by Dr. Sam Naficy and some patients may have had more than one surgical procedure performed. The text accompanying the photos describes the details of the procedures performed.
* Individual results may vary.
In a small number of patients, liposuction of the neck alone is adequate enough to make a significant improvement in the neck and produce results that approximate a neck lift. It is important to know that only a minority of patients will benefit from neck liposuction as a stand-alone procedure and that if neck liposuction is used in patients who are not good candidates, the results can be less than desirable. The ideal candidate for neck liposuction is ideally 40 or younger, has excellent neck skin tone and skin that is not too thick or too heavy, has excess fat under chin and neck that is situated under the skin, does not have any banding or laxity of the muscle, and has good bone structure in the lower face and chin. Neck liposuction is performed through 1-2 small incisions under the chin +/- a small incision behind each earlobe. In addition to liposuction, there are techniques that involve use of lasers to help tighten the skin of the chin and neck. These techniques are often known as laser liposuction, with specific brand names such as Smart Lipo or Cool Lipo. A chin implant may also be combined with neck liposuction for a better result.
Deep Neck Lift
The deep neck lift is considered the procedure that gives the most improvement to the neck with the least amount of incisions. The deep neck lift goes significantly further than liposuction in improving the neck contour. Deep neck lift is performed through a small incision under the chin, in addition to allowing removal of fat situated above the muscle, the deep neck lift allows removal of fat deep to the muscle, allows for tightening of loose neck muscle (called platysmaplasty), allows for improvement of neck bands/cords, and allows for trimming and reduction of the enlarged neck glands (submandibular glands) to improve neck contour. The deep neck lift is also the most popular neck lift procedure in men because of its limited and hidden incision and short recovery time. Where the deep neck lift falls short is in the inability to remove excess neck skin as would be possible with a lower face and neck lift.
Deep neck lift by Sam Naficy, MD. * Individual results may vary.
Suspension Neck Lift (Feather Lift, Thread Lift)
This method of neck lifting uses permanent sutures that are used to 'suspend' the sagging neck muscles in a sling-like manner. The technique requires an incision placed under the chin (same as a deep neck lift) and an incision behind each ear. The amount of improvement achieved with suspension lifts is not as much as achievable with deep neck lifts. Occasionally patients may develop a 'noose-like' feeling around the neck, caused by the suspension sutures.
Direct Neck Lift
This method of neck lifting involves direct removal of excess neck skin and the incisions run from under the chin to the bottom of the neck. The scars typically heal quite well but are not as easily hidden around and behind the ears as a traditional lower face and neck lift. This technique of neck lifting is typically performed on individuals who do not want incisions placed around the ears but have significant excess of neck skin, in particular in the middle of the neck. Bald or balding men are often good candidates for this type of neck lift.
Direct neck lift by Sam Naficy, MD. * Individual results may vary.
Lower Face And Neck Lift
The most effective, natural, and long-term method to rejuvenate the neck is the deep-plane lower face and neck lift. Because the neck and the lower face are a continuous anatomical unit, it is best to lift the lower face and neck together in continuity. Most of the incisions are around the ears and inside the hair-line. A small incision is also made under the chin. Most individuals over the age of 50 will benefit the most from this method of neck lifting. The lower face and neck lift is often combined with a brow lift and facial fat grafting for the most balanced and natural results. This method of neck lifting also results in the longest lasting improvement.
Lower Face and Neck lift with Brow lift and Fat Grafting by Sam Naficy, MD. * Individual results may vary.
Weekend Neck Lift (Cook Procedure)
The weekend neck lift or 'Cook procedure' is a modification of the deep neck lift procedure. It falls short of the deep neck lift in that it does not address excess fat under the muscle and it does not deal with enlarged submandibular glands. Weekend Neck lift (Cook Procedure) does involve laser resurfacing of the underside of the neck skin in an attempt to tighten the neck skin from inside. This laser technique has been associated with some healing problems. Most plastic surgeons have abandoned this technique of neck lifting as it typically falls short of the optimal result.
Neck Lift And Chin Implants
Chin augmentation using chin implants is often used in combination with a variety of neck lift procedures and serves to further enhance the contour of the neck and make the chin-neck angle sharper and more defined. Chin implants are placed through a small incision under the chin, the same incision that is typically used with all neck lift techniques, such that no additional incisions are needed.
Deep Neck lift and Chin implant by Sam Naficy, MD. * Individual results may vary.
Neck Skin Rejuvenation
To improve the tone, texture, and color of the skin of the neck, there are a number of non-surgical options that can further enhance the results of the surgical procedures. The tone and texture of the neck skin are often improved with Ultherapy or Thermage treatments, both of which stimulate collagen production in the skin. The color of aging neck skin, whether caused by age spots, sun spots, or broken capillaries, can be improved with intense pulsed light (IPL) treatments (also known as Fotofacial or Photofacial).
What type of anesthesia is used?
A number of anesthesia options are available and your anesthesia provider will discuss with you which one is most appropriate for your health status and procedure. Some procedures require general anesthesia, while others may be done with IV sedation. With either, your heart rate, blood pressure, breathing and oxygen levels are monitored continuously by your anesthesia provider.
General anesthesia means that you are completely asleep for surgery and the placement of an intravenous line and a breathing tube is required. Frequently, numbing medication is also placed during surgery by your surgeon.
IV sedation is also called “monitored anesthesia care” or MAC. This involves receiving sedation and pain medication through an intravenous line (IV). At the beginning of the procedure, when you will be the sleepiest, your surgeon will be placing numbing medication in the area of the surgery. Once the area is numb you will require less sedation and pain medication but you will continue to receive enough medication to keep you sedated and comfortable during the entire procedure. During your surgery you may be receiving oxygen. Airway devices may be placed during IV sedation to keep you breathing normally.
Anesthesia guidelines [21kb PDF]
There is usually some tightness around the neck and jaw-line after neck lift surgery. This can be controlled with prescription pain medication for a few days, although a small population of patients are able to treat the discomfort with just Tylenol. A fluffy bandage dressing is worn for 1-2 days. Discoloration and swelling around the jawline and neck, when present, will usually improve over 7-14 days at which point most people can return to work and social activities. Some techniques of neck lifting can have shorter recovery times of a few days. The photos below were taken at only 7 days after a lower face and neck lift surgery!
Only 7 days after Lower Face and Neck lif by Sam Naficy, MD. * Individual results may vary.
I am interested! What do I do next?
If you are considering a neck lift procedure we encourage you to complete this Surgical Consultation Intake Form. Dr. Naficy will tell you whether you are a suitable candidate for this procedure and inform you of the potential risks of the procedure. There is great variety in features of the aging face and neck so that each procedure must be custom tailored for the best possible result. You will also have a chance to view before and after photo albums of his patients who have undergone procedures similar to what you are considering.
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