Is it standard procedure to cut off excess skin when performing a neck lift only (not lower face lift)?

Question

I have had multiple consultations with surgeons regarding a neck lift and have gotten different answers regarding removing excess skin for a neck lift. One said no skin is removed, just lipo to remove the neck fat and then repositioning of the tissue with added plication and suspension suture. Another surgeon said they would potentially remove 1 inch of excess skin on either side of the neck.

David W. Rodwell III, MD · Answer

Here's the problem.  The terminology is so varied for facelift and necklift that patients end up getting completely confused. The simple explanation is that if there is loose skin excess in the neck, then the most appropriate procedure WILL involve some skin excision.  This is often best performed laterally at the side of the neck by the hairline behind the ear.  Sometimes a small amount of skin can also be removed around the submental incision (just below and behind the chin).  This method above with skin excision +/- fat removal and platysmaplasty is by far the best way to substantially improve the neck.  Patients must also be aware of the importance of considering doing a more thorough procedure to lift the cheeks and jowls at the same time.  For most patients that (facelift with necklift) ends up being a more appropriate choice than an isolated necklift.Liposuction by itself without anything else really should not be called a necklift.You could have neck liposuction with a platysmaplasty WITHOUT skin excision and still call that a necklift.  This option would only be for patients with minimal loose skin and enough elasticity to allow the skin to retract after the procedure and enhance the newly improved contour.Any neck procedure without removing skin is only an option for younger patients with good skin elasticity.

Alejandro J. Quiroz, MD · Answer

What needs to be done in surgery in regards
to the removal of the skin will depend in the capacity of the skin to
contract.  Every individuals have different
elasticity.  Also if you have already
loss skin that skin needs to be removed particularly if you are having liposuction
since is going to empty your neck and leaving loss skin

Jeffrey Ridha, MD · Answer

Like most areas of plastic surgery, there are many ways to address the neck, and the procedure must be tailored to fit an individual patient's needs. One of the reasons you are receiving varying reports is because of the uniqueness of the neck in its ability to redistribute tissue. When the skin is mobilized around the neck for a neck lift, and fat removal and/or tightening procedures are performed underneath the skin, the skin often redistributes in a way where excision may not be necessary to tighten the tissue and accomplish great results. For patients with significant true skin excess, or very thin, redundant skin, skin excision may be necessary.  I would recommend consulting with a board-certified plastic surgeon, and he or she will evaluate you, and help you to select the best procedure to meet your goals.

David Hansen, MD · Answer

It is common to remove excess skin no matter how you get a neck lifted. It is easy to do under local and with a faster recovery.

Michael J. Yoo, MD · Answer

Great question.  It depends on the quality of your skin, how much fat is present in the neck and how much your skin would be expected to retract if just the neck was defatted.  Without photos its impossible to say what would work for you.   Get more opinions from BOard certified Plastic Surgeons before settling on one.  Best wishes.

William Portuese, MD · Answer

In our practice, a neck lift is performed on patient's less than 50 years of age who have excellent skin tone and have fatty deposits in the neck that they wish to have removed. A neck lift does not involve skin removal. When patients are over 50 years of age, and have excess skin in the neck, a lower face and neck lift is performed which removes skin. For more information and many examples of both procedures, please see the video and the link below

Richard W. Fleming, MD (retired) · Answer

There are many versions of a neck lift which makes it difficult for the consumer to know what will be done. Each patient should know what the problem is, exactly what will be done, and what results to expect by seeing the results in other patients who had the same problem and same treatment. For the record I remove skin with all my neck lifts.

Ronald V. DeMars, MD (Retired) · Answer

The answer totally depends on your anatomy, and we have no indication of what that is. If there is loose skin, it needs to be removed, whether or not there is excess fat. If you have thick tight and young skin and too much fat, then neck contouring with liposuction can be done.

Is it standard procedure to cut off excess skin when performing a neck lift only (not lower face lift)?

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