Do I Need a Neck Lift or Just Liposuction? (photo)

The best recommendations to improve your neck appearance depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:
Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle.Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.

At 33, your skin tone is usually still very good and so liposuction alone should be able to address your concern, possibly with an additional submental incision. However, depending on the degree of skin laxity, there are patients in whom a better result can be achieved with a limited postauricular incision. Only an in-person physical exam can determine which method is appropriate. At 33, unless you have lost a great deal of weight and have very poor skin elasticity, or if you have other unusual factors that may impact your surgery, a limited procedure should be sufficient.

   An exam will be imperative to determine exactly what will be needed.  Supraplatsymal fat can be liposuctioned.  Subplatysmal fat and muscle laxity must be addressed with a neck lift.  Kenneth Hughes, MD Los Angeles, CA

Dear galaxsi,


Given your age and what it looks like, neck liposuction would be a good place to start

The skin is still very elastic and will re-shape to the contours of your new neck after the fat is removed

For a more definitive answer, please see a surgeon for an exam, then all of your concerns can be addressed


Best regards,

Nima Shemirani
 

Thank you for your question.  From the pictures you showed us, I would recommend an anterior approach only for your neck lift (a small scar under the chin only) with:


a conservative liposuction of the neck,

direct excision of subplastysmal fat and

repair of the plastysma muscles (plication).  


This is a 60-75 min procedure that can be done either under full general anaesthesia or under deep sedation with anesthesiologist.  This is a very common neck approach today as less and less ladies opt for a full facelift after all the great results we can get with Botox and fillers (restylane and juvederm).  Make sure you see a qualified plastic surgeon.  See my video, attached.  Hope this helps!  Dr. Marc DuPere, Toronto plastic surgeon, board-certified.

Neck liposuction alone will improve your neck. For best improvement and most longevity, a thorough neck lift will be required.

While full surgical face lift and/or neck lift in the right hands can result in the most dramatic clinical outcome, the associated downtime, costs, and potential risks may be prohibitive for some. The new gold standard for minimally invasive neck lift and reduction of jowls is SideLaze Lift utilizing Cynosure PrecisionTx (formerly known as SideLaze800) where subcutaneous tissues get tightened and fat pads melted with the 1440nm laser energy getting safely delivered right underneath the skin. SideLaze Lift when combined with judicious neck lipo or jowl lipo can achieve significant lower facial contouring with no scalpel, stitching or scars.

After reviewing your photos, I agree with many of the other responders.  I feel that you do have submental fat which would benefit from liposuction in this area.  At the same time, it appears you also have some platysmal laxity.  A midline platysmaplasty, in combination with submental liposuction, would benefit you the most.  This would allow both removal of the fatty deposits under your chin, in addition to tightening the platysmal muscles with sutures.  

From your photos it appears that you have both fatty fullness of the submentum and platysmal laxity. I think a neck procedure would give you a nice result with the best result including repositioning of the platysma muscle.  Whether this could be done with a midline platysmaplasty alone or with additional tightening laterally best discussed at your consultation.

In agreement with other responders, at age 33, liposuction would be a limited less expensive and less invasive choice that may sufficiently improve your situation...but necklift is the gold standard.  Even for young patients, necklift may be preferred because the procedure is performed under direct vision, and all problematic elements can be corrected, PLUS the result is lifelong.  Not sure what other responders mean by necklift with liposuction... for me, it's either/or.