Fix Small Amount of Extra Skin on my Neck W Incisions Bhind the Ear, No Messing W/ Muscle, Possible?

I am thin with good muscle tone, and 36. I just want to tighten some excess skin that sags at the front of my throat/ under chin after loosing weight. Can i just have the skin tightened, with incision behind my ears, without muscle tightening. I dont think its needed, it is only skin, not muscle thats loose. Im only going to get this done if i can just tighten the skin, with incisions behind the ear.

Doctor Answers 7

Neck lift with minimal incisions

Although it is hard to tell without seeing your pictures what you are describing could possibly be corrected with an incision under the chin

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Surgery or non-invasive procedures can tighten the neck.

Certainly you can have the skin of your neck tightened, and there are multiple ways to accomplish this. One way you have described is to remove skin and take up the slack behind your ears. At your young age, no muscle work would be necessary. However, there are some non-invasive techniques you may want to consider, depending on how much skin needs to be removed, like Titan laser and fractional carbon dioxide laser. Seek the advice of a reputable surgeon and see which option would work best for you.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Minimal Incision Neck-Jowl Lift

You definitely can have your neck/jowl skin tightened without manipulating any muscle. However, you can not create the skin tightening effect if the entire incision must be placed exclusively behind the ear. That will not create the desired effect without distorting the earlobe. It is necessary to at least have some of the incision come around the earlobe in the front.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Yes, a skin only necklift is possible, but may need tissue glue to help support the skin

Hi Philadelphia7808,

When examining a patient with loose hanging skin under the chin, I check to see if the skin band is actually the platysma (neck muscle) band protruding through the skin.   I will ask the patient to clench their jaw and flex their neck so they feel pressure pulling up on their collar bones.  The platysma muscle is attached from the collar bone to the sides of the jaw.  If the skin band protrudes even further, then I would not perform a necklift by only pulling on the skin from the sides.  Why?  The surgeon can tighten the outer part of the platysma muscle behind the ear and then the excess skin can be trimmed from the incisions behind the ear; however, the platysma muscle does not like to be pulled to the side, and the platysma muscle will want to return to its original position.  When the muscle returns to the original position, since nothing was done to the muscle band, it can protrude again and it will look like the skin band has returned.  

I think that you bring up a good point regarding just removing skin.  The main reason why there is a "lateral necklift" which is pulling on the platysma muscle from the sides in order to trim off the extra skin, is that if the skin were simply separated, there may not be much "slack" to trim.  By not separating the tissues under the chin and pulling on the deeper structures allows the surgeon to use the strong tissues under the skin to pull on the skin itself.  However, in my experience these stronger tissues may have a tendency to return to its original position and subsequently pull the skin back with it.  This can result in a return of skin laxity under the chin as well as thickened scars behind the ears in some cases.

There is a new technology called tissue glue (Tisseal and Artiss).  Tissue glue is a product processes human blood products which clot the blood, and use it as a glue to hold tissues together.  Tisseal has been FDA approved for heart surgery, brain surgery, and other medical uses, but more recently a diluted version of Tisseal, called Artiss was FDA approved for skin grafts for burn victims.  Baxter, the medical company which makes Tisseal and Artiss, recently got an FDA approved indication specifically for Face and Necklift surgery called Artiss.  

By using tissue glue, the extra skin can be freed from under the chin and all the way to the back of the ears, and the excess skin can be pushed back without performing a corset platysmaplasty, as you suggested.  The Artiss tissue glue can help to hold the extra strength needed to support the skin removal, without pulling on the deeper tissues.  If I were to perform a skin only necklift, this would be the way that I would do it.  If I didn't use the Artiss Tissue Glue, I would worry that the skin incision would be holding all of the strength of the skin removal, and cause an ugly scar.  Using the tissue glue allows the skin to stick down like "duct tape" and then the incision itself, doesn't have much pull on it, and can make for a finer scar.

I hope that helps.  Good Luck on your plastic surgery journey.


Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Necklift removes the extra skin.

Necklift removes the extra skin with or without tightening the muscle. I would have to see you to see to determine what is possible.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Neck Skin Tightening

Basically, yes, you can have the skin tightened without the muscle tightened.  You are young enough where you may not need muscle tightening.  However, without seeing pictures or seeing you in person, it is impossible to give you specific advice.  If you are just having the skin tightened in a neck lift, you will just have small incisions hidden around your ears.  If you need the muscle tightened, you will also need small hidden incision under your chin.


Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Skin versus muscle and skin for a necklift

A simple way to determine if your waddle is a result of skin only is to look in the mirror at rest. Look at your waddle and then move your lower lip downward (do not use your hand - lower the lip with the lip and neck muscles). If the waddle moves downward and separates a little, then the waddle is likely muscle (with or without excess skin). If the waddle does not change much, then you have a skin only waddle.


Good Luck!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.