What's the difference between an extended neck lift vs a lower face lift?

Question

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.​  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

How are an extended neck lift and lower facelift different?Different doctors term their facelifts and necklifts differenty.The operation itself usually requires limited incisions within the ear, the sideburn, and around the earlobe. These are well hidden and will become nearly invisible with time. The strong layers under the skin that support the jowl and neck are lifted with long lasting sutures that define and rejuvenate the jawline and neckline. This part of the LiteLift™ takes about two hours. Additional minor procedures can be added on to enhance the rejuvenation of this fast-recovery lift. The extended necklift may involve a longer incision behind the ear and hairline and under the chin.

Alejandro J. Quiroz, MD · Answer

Thank you for your question. The lower face lift will treat any conditions from the lower eyelid to the jaw line. Any other condition from the jaw line to the collar bone will be consider a Neck Lift.

Stephen Prendiville, MD · Answer

A facelift is commonly understood to address the cheeks, jowls, and neck.  Typically, a "neck-lift" will only address the neck without the jowls or cheeks.  As others have mentioned, the terminology mentioned above can vary from Surgeon to Surgeon based on their preferences and techniques used.  It is important to understand that the anatomical component that ages in the neck, leading to banding/ cording is the platysma muscle, which actually starts in the lower face.  In my experience, patients are generally more satisfied with facelifts, because it allows for addressing the platysma in the lower face and neck, in addition to contouring the other aging areas in the face.  There is nothing wrong with asking your Surgeon what specific components will be addressed with the proposed procedure and ask to see lots of before/after pictures.  Good luck!

Zoran Potparic, MD · Answer

It is very individual and sometimes very confusing nomenclature used in neck and facial surgery related conversation with our patients.There is a transition zone over lower jaw (jowls, jawline, mandible angle) which frequently needs to be addressed and can not be properly approached without making "facial addition" to a neck lift. Cleaning this area from fat and lifting it would require lower face lift in association to neck lift. This is an issue that you can clarify only with your surgeon(s) based on what they want to correct. Good luck.

Larry Weinstein, MD · Answer

Some necks are more extensive then others. An elderly woman with wrinkles to the sternum requires more time  and skill for an effective improvement then a younger patient with a small waddle. An extended neck lift would involve a complete dissection of yhe meck skin and addressing the platysmal muscle component by lateral SMAS elevation or imbrication medially. Good luck.

Arnold Almonte, DO · Answer

Thank you for your question. Every surgeon defines their “facelift” and “necklift” differently. Essentially the goal is to rejuvenate and tighten the lower half of your face. Each face and neck are different so surgeons adjust where they place the incisions and where the emphasis of the work is. Some patients need more work under the chin, some need more work at the jowls and jawline. Regardless of the name of the procedure, your surgeon is trying to identify the treatment that will suit your needs best. A thorough surgeon will answer all these questions at the consultation. Seek out an experienced face specialist. Good luck.

Patrick Flaharty, MD FAACS · Answer

A full lower face lift is typically performed with a neck lift to rejuvenate the lower face and neck in a harmonious way. An extended neck lift refers to a full lift of the neck which is often done with a lower face lift but can also be done as an isolated procedure. Isolated neck lifts are often a secondary procedure done a number of years after a lower face and neck lift procedure to retighten the neck.  Surgeon many all use slightly different nomenclature to describe each procedure they perform so the best information can be gained during a face to face consultation.

William Portuese, MD · Answer

In our practice, a neck lift does not remove any loose skin in the neck, just excess fatty deposits in the neck and a platysma plasty. A lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing the fat in the neck and a platysma-plasty. For more information about the two procedures and many examples, please see the link and the video below

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.  
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience, this is the "key" factor in making the face soft, feminine and naturally beautiful.  An essential part of any facelift on a woman.  Conversely, men look chiseled and handsome when angularity is created in the cheeks, chin and mandibular angles.  The ability to provide precise, facial shaping separately or in combination with a facelift is in my humble opinion the definition of a "facial shaping expert".
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiaproper SMAS Imbrication techniqueno incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Along with the minimally, invasive SMAS facelift described above, some of the excess skin below the chin can be removed using a small, curved incision under the chin.  This along with skin removed in front and behind the ear will tend to reduce the skin excess by around 70% or more.
 If anterior platysmal bands are present or the maximal amount of neck skin is to be removed, a "formal" neck lift can be done.  In this procedure, the face and neck tissues are elevated using a curved incision around the front (explained later) of the ear that continues in the crease behind the ear and then 3 inches into the posterior hairline.  The tissue is dissected from that point all the way across the entire neck to the same position on the other side of the head in a dissection that is as long vertically as the entire neck.  The Platysma muscles are tightened using a curved incision under the chin and each side is pulled upward and back again being tightened at a line behind each ear (under the tissues).  Since the skin flap pull is up and back, this will pick up any tissue laxity along the jaw line or "jowls" which must be dissected and flattened out using a lower facelift (incision around the front of the ears).  If this isn't done, pleats of excess skin will appear below each ear.
 This is an extensive surgery taking 4 1/2 to 5 hours with large incisions, requires placement of drains, possible hair loss and months of recovery.  The difference between all of these procedures is length os anesthesia, incisions, tissue dissection = bruising/swelling and recovery time.Hope this helps.