THE SHAPE OF THE NECK
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/or a lower positioned hyoid bone.
OPTIONS IN NECK CONTOURING
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-Invasive Neck Contouring
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., Skin Tyte, Exilis) to create some mild skin tightening effects. Injectable Botox can be used to treat prominent neck (platysmal) bands. Fat dissolving injections (lipodissolve) can also be done for small amounts of neck fat reduction. 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 sub-mental 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 different names (e.g., Lifestyle Lift, Quicklift), 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.
Adam’s Apple Reduction (Tracheal Shave)
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.
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.
Cosmetic Procedures – Neck Contouring – Before Surgery
The consideration of neck contouring requires a thorough pre-surgical discussion. There are numerous methods available to reshape a full or droopy neck. The amount of fat, loose skin, and neck and jowl line shape are all taken into account when considering the best option. There is also the issue of how much recovery a patient needs versus how much of a neck change can be achieved. Generally, younger patients with fuller necks and good skin elasticity benefit from liposuction and sub-mentoplasty techniques. Patients with jowling and some loose neck skin need limited versions of facelifts. Patients with larger amounts of loose neck skin and neck wattles need full face and neck lifts.
Cosmetic Procedures – Neck Contouring – About the Operation
Neck contouring can be done under local anesthesia, IV sedation or general anesthesia depending upon what type of procedure is being done. Neck liposuction and submentoplasties can be done under local or IV sedation anesthesia. Limited or full facelifts get better results when done under general anesthesia. All of these procedures are done on an outpatient basis.
Neck liposuction uses laser (SmartLipo) technology to remove fat and tighten neck skin. A submentoplasty uses a small incision under the chin to tighten the neck muscles and liposuction to remove fat to reshape submental fullness and loose skin. Facelifts (neck lifts) use incisions in and around the ears to lift and remove loose neck and jowl skin. Dissolvable sutures are used around the ears so their removal is not needed later. Most facelifts also include liposuction of neck fat (limited facelift), submentoplasty (full facelift) and, occasionally, chin augmentation with an implant.
Neck Contouring – After Surgery
All types of neck surgery benefit by compressive garment therapy for about one week after surgery. Keeping the reshaped neck skin adapted to the underlying tissues helps it heal (stick down) and make it as smooth as possible. It also keeps down some of the swelling. Full facelifts require the use of a drain to remove fluids from under the skin, which is removed one day after surgery.
The biggest concern after neck surgery is to have a better defined neck shape and skin that is as smooth as possible. The final results after neck contouring can take up to six weeks to see . Neck liposuction results will take longer to see than any form of neck skin tightening due to prolonged swelling and small irregularities that take time to settle down and go away.
Neck Contouring Costs
- Neck Liposuction (SmartLipo) $2,500
- Submentoplasty $3,500
- Limited Facelift $4,750
- Direct Necklift $ 4,250
- Full Facelift $7,500
(Fees are approximate)