Can I Have A Combined Necklift and Jaw Augmentation At The Same Time?

Q: Dr. Eppley, I have a lot of neck sagging and lack of jaw prominence and s short chin. I would like a total jaw augmentation as well as a necklift. What do you think? 

A: Thank you for your inquiry and sending your pictures. Your case poses a bit of a conundrum as the jaw augmentation and the neck lift are linked, not only by anatomic proximity but by their aesthetic effects. Normally in older men with more modest signs of jowling and neck sagging can be adequately improved by the placemcent of a custom jawline implant alone. But your degree of neck sagging is too advanced for the effects of a jawline implant alone to adequately address it. In fect the posterior 2/3s of a jawline implant would not be seen at all. Only the effects of the chin portion would be able to be seen. Thus a necklift (full lower facelift) is absolutely needed.

Point #1.  You can have a necklift without jaw augmentation but you should not have a jaw augmentation without a necklift.

A custom jawline implant and a necklift can be combined but that makes for a challenging recovery particularly in terms of swelling. The normal swelling from a jawline implant could have a negative effect on the necklift results.

By its open exposure at the back of the jaw angle and ear a necklift provides the opportunity to use that exposure for aid in placing the jaw angle portion of a custom jawline implant. But due to thicker tissues in men that is more challenging to do so than in women

Point #2 A necklift and custom jawline implant can be combined but should they??

Ideally one would have a necklift first and then a custom jawline implant secondariy. And one could argue that to maximze the benefits of both this is how it should be done. An altternative strategy, and an historic one, is to combine a necklift with chin augmentation. Get the most forward part of the jaw more projected as chin augmentation has no negative effects on the results of a necklift and actially makes its results even better. The needed submental incision for the central part of the necklift provides a convenient opportunity to place an extended chin implant. If a total jaw augmentation effect is desired later the expansion of the chin soft tissues  makes the placement of a custom jawline implant a bit easier.

Point #3 An amalgamated approach of  a necklift and chin augmentation blends the two surgeries without making the recovery more difficult and provides some structural enhancement to the necklift as well.

In conclusion the two approachs and their advanatges and disadvantages are:

#1 Necklift + Ciustom Jawlne Implant =  One stage approach, maximum recovery but with maximium result. The swelling from the jawlijne implant may have a slightly negative effect on the necklift result.

#2 Necklift + Chin Implant = Two stage approach, more traditional necklift recovery, gets some of the jaw augmentation benefits, one may or may not go for more complete jaw augmentation later.

Dr. Barry Eppley

World Renowned Plastic Surgeon