Best Type of Neck Lift for a Female in Mid 20s? Is It Too Young for a Neck Lift to Correct a Hereditary Low Hyoid Bone? (photo)

Question

I have never had a neck angle. I thought liposuction would help but after seeing several Board Certified surgeons, it is clear the main problem is a low hyoid bone/ muscles and a weak chin. The advice is a neck lift followed later by fillers or a chin implant. Are there any lifts that help specifically with this problem this in younger patients? I have had several types recommended (trampoline/ corset). What is recovery like? How long does swelling last? Are there any risks having it so young?

Kenneth Hughes, MD · Answer

I cannot tell whether a chin implant would be appropriate with the pictures. This can be combined with liposuction if you would like. I will tell you that platysmal tightening in a person with your anatomy usually produces the most significant improvement in contour. Find a plastic surgeon with ELITE credentials who performs hundreds of necklifts and facial procedures each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Jason Emer, MD · Answer

​A combination of non-surgical options like Kybella, PDO NovaThreads, Ultherapy and Thermage would do well in combination for skin tightening for the neck. VASER Liposuction (with ThermiRF, Renuvion and InMode FaceTite) is a great alternative for contouring and tightening the chin and neck and can be combined with a neck lift at the same time, if you're a candidate. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a long-term treatment plan that works for you. Best, Dr. Emer.​

Robert F. Centeno, MD, FACS · Answer

Thank you for your question and photos. You have properly identified the anatomical problems. A small chin implant and a suture suspension neck lift would give you an improved neck angle as well as definition of your mandibular angle. It involves platysmal plication with suture suspension.  Best wishes.

Toby Mayer, MD · Answer

Without an exam I would tell u NOT to have this surgery since the lift will not lift the neck muscles attached to the hyoid.

Todd C. Miller, MD · Answer

I frequently see patients like yourself and I love managing this problem. It's true that you have a low hyoid bone but I don't agree that a neck lift is necessary. In my experience liposuction can provide a very nice, natural improvement to your crevice-mental angle (angle from the chin to the neck). If you want to enhance it even more I would recommend a chin implant. In my experience, patients such as yourself can get great results with these simple procedures. Consult with at least two experienced facial plastic surgeons before moving forward.

Shannon O'Brien, MD · Answer

Thank you for the questions and photos. At your age and from what I can see in the photos, I would be very unlikely to recommend a true neck lift. Whether you would benefit more from liposuction or direct removal of fat through an incision under your chin is difficult to tell without an exam, but I feel that either of these would probably be better than a neck lift at your age. Correcting the chin projection with an implant would elongate the appearance of your jawline and therefore improve the shape of your neckline. Good luck with these tough decisions.

William Portuese, MD · Answer

Fat is present in both the sub-mental and sub-platysmal space. The only way to remove the sub-platysmal space is to place a 1 inch incision underneath the chin and manually remove it under the platysma muscle. After the fat has been removed the, platysma muscle must be closed and sutured together. There is no skin removal in this type of neck lift . This will give a improvement in the jawline. There is no surgery that can be performed to help a low hyoid bone. Occasionally a chin implant is also performed when there is a recessive chin. The implant is placed through the same incision. Please see the link below for examples of neck lift and chin implant and our practice.

Anita Sethna, MD · Answer

I agree with my colleagues that given your age, a necklift is both less likely to be necessary and also not likely to get you the results you are looking for. A necklift addresses excess fat under the chin, but is more focused on removing excess skin. At your age, the likelihood of excess skin is very low. Given the photos above, performing liposuction to address excess fat in the area under the chin would be a good first start, as long as it's not too aggressive. If your chin is weak, placing a chin implant gives the neck a much longer fulcrum on which to hang, giving the impression of an improved angle. Both of these together may serve to improve the neck to a much greater degree than either alone. Best of luck to you!

Darryl J. Blinski, MD · Answer

At your age I believe minimal invasive therapies like ThermiTight RF would address these issues than having a major operation.

Stephen Weber MD, FACS · Answer

A necklift is NEVER the best option for someone in their 20s. Liposuction is often perfectly adequate because a person of your age has good skin elasticity and the skin typically contracts following liposuction resulting in a tightening effect. If you do have a weak chin, a chin implant will also typically help improve the neckline and profile. Unfortunately, a low or forward-projected hyoid is something that cannot be remedied. Even a complete facelift in someone with a poorly positioned hyoid and voicebox will typically result in a sub-optimal result. In many cases, a chin implant and liposuction can create a measurable improvement in someone with your concerns. I hope this information is helpful.

	Stephen Weber MD, FACS

Best Type of Neck Lift for a Female in Mid 20s? Is It Too Young for a Neck Lift to Correct a Hereditary Low Hyoid Bone? (photo)

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