Can A Direct Neck Lift Be Done With A Shorter Vertical Scar?

Q: Dr. Eppley, I am interested in a direct neck lift but have concerns about the length of the neck scar. I have had two facelifts but my neck wattle persists so I am tunring towards a more direct approch. Here are some pictures as I do not like my profile. Can I direct neck lift be done with a shorter scar?

A: There is no question that the final ‘piece’ to optimizing your facelift result is the central neck area. In a traditional direct neck lift, the bottom portion of the scar ends in an inverted T shape excision of skin along a horizontal skin crease which is usually over the thyroid cartilage. (most people perceive that it ends in a straight vertical line but that is a misconception) It ends like that to work out any excess skin. What really creates the sharp neck angle (besides the tissue excision) happens above that at the cervicomental angle) In a shortened or more limited version of a direct neck lift, the lower end of the scar can be completely vertical. (the upper end is now an upright T at the submental skin crease) This now becomes what is more classically perceived as a submentoplasty. This can certainly improve your neck wattle but not to the degree of the classic direct neck lift with the lower scar location. In conclusion, as long as the scar does not drop below the cervicomental angle area then that would be a good compromise between improvement and the creation of a scar.