Will A Direct Necklift Help Improve The Appearance Of My Saggy Wrinkly Neck?

Q:  Dr. Eppley, I am 59 years old with a younger looking face and body but an old, wrinkly neck. My neck does not match the rest of my face or body and makes me look old. From what I’ve read, a direct necklift may work to improve the appearance of my neck but would be of interest to me since it may cost less  but I’d like to know what you think. I have attached some pictures which shows my wrinkly saggy neck.

A: Thank you for your inquiry and sending your photos. You have a most unusual amount of neck aging compared to that of your face. And the direction of your neck sagging is mainly horizontal and not vertical. Many men develop so called turkeynecks which are largely a vertical skin sagging problem. This is the typical direction that direct neck lifts treat which is a vertical neck skin removal with some minor horizontal skin removal at both ends of the vertical excision.

Your neck, however, shows a substantial amount of horizontal skin laxity as seen by your many horizontal neck wrinkles. This indicates that a direct necklift for you must have a different excisional pattern. Using your horizontal neck wrinkles, two to three inches of neck skin can be removed across the width of the neck keeping the final scar in a horizontal neck wrinkle line. The only question is whether a vertical component to the skin excision needs to be done as well. I can not tell that from your photos since your face is tilted upwards in the photos you sent which may artificially make any neck wattle look better than it really is.

There is also the option of a more traditional facelift approach which will also work very effectively as well, albeit with more recovery and expense.

Dr. Barry Eppley

Indianapolis, Indiana