Indianapolis Neck Contouring Provider
Dr. Barry Eppley

The shape of the neck is one of the most defining of all facial structures. Its angle and definition can help the jawline and chin stand out or make it more obscure and unflattering. It influences the perception of the entire lower third of the face. A tight neck with a good cervicomental angle creates the impression of youth with the appearance of a smooth and well-defined jawline. Unfortunately as we age, a once good neck shape changes as the tissue becomes loose and sags. For other people, regardless of age, they have a naturally full or thicker neck due to a thicker fat layer and a lower hyoid bone.

While genetics and aging are out of our control, the good news is that a variety of plastic surgery procedures for the neck are available. Excess fat, sagging skin and loose muscles can be treated to achieve a smoother and uplifted neck shape. A neck reshaping procedure is an excellent treatment because it takes into account one's age, quality and amount of loose skin, how much neck fat is present, and the natural shape of the jawline and chin projection.

Non-surgical neck reshaping methods abound but are not suitable for most people that seek real neck changes. Small amounts of jowling and neck sagging in younger patients with good skin elasticity can be treated by various external energy therapies (e.g., BBL or Skin Tyte) to create some mild skin tightening effects. Injectable Botox can be used to treat prominent neck (platysmal) bands. These are bridging therapies for those that don't yet need surgery or for those who do but want to try a non-surgical approach first.

Necks that have a full shape, often in younger patients, can be treated by fat extraction alone. Getting an improved neck shape with fat removal relies on the skin shrinking back to reveal the underlying muscular anatomy. My preference for neck liposuction is to use a laser-assisted method. The SmartLipo laser probe not only helps melt fat, but the heat also provides some skin tightening as well. This works with one's own natural skin retraction as the tissues heal.

An extension of neck liposuction is the submentoplasty procedure. This is an isolated neck tightening operation that removes fat by liposuction but also tightens loose neck muscles (platysma) and removes some submental skin as well through a small incision under the chin. Also known as a submental tuckup, it is used for early neck aging patients with good skin and as a secondary revision or tuckup procedure after a facelift when there has been some rebound relaxation of central neck tissues.

Facelifts, often confused for what they really do, are really procedures that primarily change the neck and the jowls. They are probably better thought of as neck lifts. There are two fundamental types; limited and full. Both use incisions around the ear but the length of the incisions and what effects they create in the neck and jowls is different. A limited facelift, which goes by a lot of marketing names (Lifestyle Lift, Quicklift etc), has as its main effect the smoothing out of sagging jowls with a more limited effect in lifting neck skin. It is best used in patients whose primary complaints are about their droopy jowls and not their necks. Full facelifts are used when the neck problem is more significant and its improvement is the main objective of the surgery. It is the most powerful changer of both the neck and jowls and usually also incorporates liposuction of neck fat and tightening of the platysma neck muscles. Chin augmentation with a facelift can also be helpful in giving a more defined jawline.

One other approach to the sagging neck is that of the direct neck lift. Unlike facelifts in which the incisions and the direction of skin lifting is based around the ears, the direct neck lift removes loose neck skin by excising it down the center of the neck. This is a simpler approach to a neck lift and is a very powerful reshaping method of the neck, but it does so with the trade-off of a midline neck scar. This can be a preferred procedure for older men (over the age of 65) who prefer the least recovery and have large hanging neck wattles. Male beard skin heals remarkably well and I have not found the neck scar to be a visible concern after it heals.

The last area of neck reshaping, which has nothing to do with age, is the prominent Adam's apple or thyroid cartilage. For those that have too strong of a neck bulge caused by the strength of the paired cartilages of the Adam's apple, this can be reduced by shaving the prominence down. This is done through a small horizontal neck incision directly over the prominence. It is a virtually painless procedure with little to no recovery time with immediate results. Most patients obtain results where the size of the bulge is dramatically reduced and a few will have a completely smooth neckline.

Please visit our neck contouring results page to view before and after pictures of our Indianapolis plastic surgery patients who have undergone this cosmetic enhancement procedure.

For older Indianapolis neck lift patients seeking to restore youthfulness, neck reshaping can be combined with a range of other procedures offered at Eppley Plastic Surgery. Dr. Eppley is a skilled Indianapolis facelift surgeon and has helped many cheek augmentation and eyelid surgery Indianapolis patients accentuate their natural beauty.