I have loose skin in the center of my neck, but face is firm with little/no jowling. After many consultations I met with a respected b.certified p. surgeon who suggested a skin-only lift (no platysmal work). Incisions will be front of ear lobe, around back of ear and into and down the side of scalp. The scars worry me, as am active and like to be unconcerned if my hair blows around. Is there another approach to the incisions? Another p. s. suggested filler and laser instead of surgery.
Skin Only Neck Lift, and Incisions?
Doctor Answers (13)
Excess neck skin best done with neck lift.
Excess neck skin best done with neck lift.there are ways to hide the scars in the hair. Incisions that only go onto the ear do NOT remove asynchronous excess skin. Do not waste money on skin tightening procedures which give very minimal results!
The only real cure to extra skin is a knife. A knife means scars. You can have great scars and a great result that someone would really have to look hard to notice. All the non surgical options will give marginal results and still cost a ton
Skin Only Neck Lift Is Usually Disappointing
Thank you for your question. In my experience a skin only neck lift done through incisions around the ear usually results in recurrence of neck skin laxity in a short period of time.
I believe this happens because of Platysma Muscle laxity that is not yet visible pre-operatively. In addition the neck skin must be undermined and loosened through the chin incision to allow for maximal tightening when the skin is lifted or pulled tight from the incisions around the ear.
Because of this experience I almost always do an incision underneath the chin to tighten the Platysma Muscles.
Fillers and laser resurfacing will not tighten neck skin and this advice sounds like it was given by someone who does not do neck lift and face lift surgery. As a general rule resurfacing lasers should not be used on the neck skin surface because neck skin does not heal well after laser treatment.
If there is fat beneath the loose skin on your neck and you have minimal or only a small amount of loose skin in some cases laser liposuction can be effective.
It sounds as though your face is in good shape and I agree that with an active lifestyle you may want to avoid incisions around the ear. If a 10-20% tightening will suffice, non surgical options like Ulthera or Thermage may be enough.
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Does a skin only neck lift provide good results?
Pictures would be very helpful. In my opinion, skin only neck lifts risk disappointing results. The platysma muscle is a major cause of the sagging effect in the neck. Even if it looks like the problem is sagging skin, frequently, there is muscle laxity under the skin. The incisions are very easy to camouflage and scarring is rarely an issue. Let me qualify my last statement by stating that it is rarely an issue if you don't smoke, are not a diabetic, do not take steroids, and do not have a history of keloid formation.
Incisions usually can be well-hidden
The incisions usually can be well-hidden, even when the hair blows. Ask your surgeon to show you pictures of other patients' incisions to get a better idea. There are short scar techniques that sometimes can be used to limit incisions behind the ear. Without a personal consultation, however, I can't determine whether you would be a good candidate. The Incision in front of the ear lobe can generally be very well hidden even with the hair up. The platysma is a thin muscle just beneath the skin and, in my experience, the aging process virtually always involves relaxation of the platysma, as well as the skin. Again, before and after pictures can give you a better idea of what kind of improvement you can expect. Fillers are not going to help changes in the neck caused by aging, and laser treatments would provide limited benefits.
Neck lift with or without skin removal
A traditional neck lift can be performed with or without skin removal, but usually involves fat removal above and below the platysma muscle as well as tightening of the platysma muscle in the midline. If skin needs to be removed there will be an incision behind the ears and along the hairline which usually heals quite well if properly performed. Please see the link below for our neck lift photo gallery
Neck lifting options
I would doubt that you would get any lasting result with just laser and injections. A short scar facelift would be a better alternative. It is not possible to comment on the status of your platysmal muscle and separation with out a photograph. You did not mention your age and the condition of your skin and elasticity as all of these factors are important to assess.
Neck lifting makes such a great improvement in so many patients and is easy to undergo.
I would advise for you to keep seeing other consultations until you feel comfortable with your doc and what he/she is advising. Neck lifting can be done under local anesthesia and may or may not involve the platysmaplasty. Sincerely,
Neck Lift Incisions and Options
Thank you for the great question. Based on the description of the incisions, it seems like the surgeon was suggesting a truly isolated neck lift which would have a posterior or horizontal pull (the skin would be taken out along the posterior hairline). This can be a good option in a very limited number of cases... without photos and a physical exam, I couldn't tell you if this would be true for you. In my opinion, and that of others here, a better option is a lower face and neck lift with a vertical pull. This will last longer and look more natural.
Necklift Incisions and Platysmal Muscle Tightening
I suspect that the proposed incisions go further in the front of the ear that just the earlobe and would be necessary to really get a necklifting effect. Properly placed incisions in and around the ear can heal very inconspicously. Most neckllifts do benefit from some platysmal muscle tightening but that would depend on what your physical examination shows.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.