Over 80 pound weight loss - Wattlectomy or neck lift? (Photos)

Question

I have recently lost over 80 pounds and also have a genetic predisposition to having a wattle. I am wondering if I should get a neck lift or wattlectomy? Pros and cons? Expected outcome? I dont care about jowls or smile lines - just want this loose skin gone! Thank you! I’ve only found men hav this procedure and appreciate your insights

Julia Spears, MD · Answer

Hello, and thank you for your question! First, congratulations on your 80+ pound weight loss! That is an incredible accomplishment. Significant weight loss often leaves behind excess neck skin and tissue laxity, especially in patients with a genetic predisposition toward fullness in this area.

A neck lift can improve the jawline and neck contour by tightening deeper tissues and re-draping the skin through incisions hidden around the ears. However, in patients with more substantial loose skin after major weight loss, a neck lift alone may not always remove enough excess tissue to achieve the most dramatic improvement.

A wattlectomy can more aggressively remove hanging neck skin, but the tradeoff is a more visible scar beneath the chin or along the neck. In some cases, combining techniques provides the best balance between contour improvement and scar placement.

It is also important to understand that the face and neck function as one connected aesthetic unit. While your main concern may be isolated to the neck, many patients after significant weight loss also experience volume loss and tissue descent in the lower face. Some patients ultimately achieve the most balanced and natural-looking result when the lower face and neck are treated together.

The best approach depends on your anatomy, skin quality, goals, and comfort level with scars and recovery. A detailed consultation with a board-certified facial plastic surgeon can help determine whether a neck lift alone, direct excision, or a more comprehensive face and neck rejuvenation approach would give you the most satisfying result.

Jeffrey H. Spiegel, MD · Answer

Don't focus on just one area.  It's penny wise and pound foolish and will result in a mediocre outcome,  You need a full facelift and necklift, likely with a browlift.  If you feel like that's "not you", you need to consider this as part of the weight loss process. Looking healthy is part of the reward for being healthier, and an important component of health.

Carl Truesdale, MD · Answer

Congratulations on your weight loss &mdash; that is an incredible accomplishment. Exploring options to address the excess skin after such significant changes is often the final step in helping patients feel fully refreshed and confident in their appearance. Based on the pictures you shared, you appear to be an excellent candidate for a deep plane face and neck lift. Performing the face and neck lift together is the most optimal approach because it allows the deeper facial and neck muscles to be lifted and repositioned as one continuous unit, creating a smoother, more natural, and longer-lasting result. This procedure not only removes the excess loose skin, but also restores support to the underlying facial structures that have descended over time and after weight loss, helping redefine the jawline and improve the neck contour.
In addition, facial fat transfer can be an excellent complementary procedure to restore volume loss in areas such as the cheeks, temples, under-eyes, and around the mouth. Weight loss and aging often lead to facial deflation, and replacing that lost volume helps create a softer, healthier, and more youthful appearance. Combining fat transfer with a deep plane face and neck lift provides the most comprehensive full face and neck rejuvenation by addressing both skin laxity and volume loss at the same time. The overall goal is to achieve a refreshed, natural appearance while maintaining your unique facial features. Thank you for your question!

Over 80 pound weight loss - Wattlectomy or neck lift? (Photos)

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