Can I Have A Direct Necklift After A Facelift?
Q: Dr. Eppley, here are a few photos of my necklift result. You can see that the results of my traditional neck lift were not bad, just not as well as I hoped for. I do have the lateral scar under my chin and scars behind my ears so my surgeon did tighten my skin. As I mentioned I do have a sharper jaw line and thinner neck but not quite the neck angle I expected. If I place my thumb in the crook of my neck and slightly pull the loose skin to one side, it looks exactly the way I wanted my surgery to turn out. If that can be achieved by a direct neck lift then I would consider that option. Can you tell me what that runs price wise and is it common enough that most surgeons would be adept at that procedure?
A: While I have no idea what you looked like before your traditional necklift, those results look very good to me and are about the best you could have hoped for. Because of potential hairline and beard skin distortions and the heaviness of male facial skin, it is usually not possible to have a very sharp or close to 90 degree neck angle. To have thought otherwise suggests a fundamental misunderstanding in the preoperative consultation/education process.
A direct necklift can make that final change into a sharper neck angle if one has some tolerance for a midline neck scar in the depth of the neck angle area. Whether you would have a favorable scar depends on how tight the skin is in that area. Loose neck skin in the older male when a wattle is present heals remarkably well. Tight skin in a middle-aged male may be at higher risk for hypertrophic scarring.
Dr. Barry Eppley