50 years old female, is the 5 layer neck lift something new or not commonly done?

Question

I was told that I would benefit from the 5 layer neck lift. I was trying to find out something about this procedure versus "regular " neck lift. But there is not much information about it. Is that something new or not commonly done? I am 50 years old female. Thank you.

Philip S. Schoenfeld, MD, FACS · Answer

So I am familiar with this technique.  The author of the article and technique has described his management of the digastric muscles using plication and not simply trimming in order to elevate the submental space and create a cleaner neck line.  It is a technique that has been utilized but not objectively studied nor named prior to this paper.   I think that most skilled facelift surgeons are utilizing some form of muscle, fat, and gland alterations beneath the platysma muscle in order to create an appropriate neckline.  The trademark names that appear are no different than a Pony Tail facelift or any other procedure that creates a name to fit a surgical technique.

Jeffrey Lisiecki, MD · Answer

Phrases like "5 layer neck lift" do not typically have any real surgical definition, and are often thrown around as a kind of branding/marketing for procedures that are commonly done.  Not knowing the specifics about who is using this phrase or what exactly they mean by it, there are many layers of the neck that are addressed in a neck lift procedure as needed.  If you have large submandibular glands or anterior digastrics, they can be reduced.  If you have fat under the platysma muscle, it can be cut out.  If you have laxity or banding in the platysma muscle, it can be repaired.  If you have extra fat above the platysma, this can be removed with liposuction or excision.  If you have loose skin, it can be lifted and tightened.  There are your 5/6 layers!  These are all done as part of a neck lift procedure as needed on an individual basis--not everyone has large submandibular glands that need to be reduced, for example.

Jacob Tower, MD · Answer

Hello, hope you are well. A '5 layer neck lift' is not widespread terminology. It is probably not anything new, but neck lifts can vary significantly from person to person in terms of which tissue layers need to be addressed. We essentially have skin, fat, muscle, and salivary glands that can be tightened, removed, reduced, repositioned, etc. Sometimes a neck lift is simply fat removal. Sometimes it's simply skin re-draping and tailoring. My guess is a '5 layer neck lift' is supposed to convey the complexity of dealing with all of these tissue layers in one procedure. But the easiest way to find out . . . ask your surgeon the about the 1-, 2-, 3-, and 4-layer options as well and what makes those inadequate for you. They will be able to point out each issue with your neck and how it's addressed. I always tell my patients: "You have to know what you are signing up for."
Best,Dr. Tower

Jeffrey M. Darrow, MD · Answer

There are only 3 layers which are routinely dealt with for a facelift/necklift. 1) the skin, 2) the layer of fat which is just under the skin and the platysma muscle.  Occasionally a fat pad just beneath the platysma muscle, or the prominent salivary glands, which are in the same layer, requires trimming to give the best neck contour, however, lifting and smoothing of the platysma muscle, the fat layer and the skin are the 3 layers needed to rejuvenate the neck and face.  Someone claiming they perform a “special” procedure, that you can’t find any information on should make you pause and reconsider.  Best wishes.

William Portuese, MD · Answer

We have never heard of a five layer necklift. A full  set of facial photographs from all angles are required to make a determination about the proper procedure for you. At age 50, you're probably a candidate for a lower face and neck lift which accomplishes tightening lose facial and neck skin, tightening a loose facial and neck muscles, lifting the jowls, and removing the fat deposits in the neck itself which are located both above and below the platysma muscle. This also includes a platysma plasty to significantly improve the jawline.

50 years old female, is the 5 layer neck lift something new or not commonly done?

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