Can a neck lift fix my obtuse neck? Or is a low hyoid causing it? (photos)

First, congratulations to your result. Your dental occlusion improved a lot, as has your profile. The deep mental crease has effaced. It is right that the position of the hyoid bone affects the mentocervical angle. The hyoid is also related by an anatomical structure to one of your horizontal neck folds. By moving the lower jaw forward the soft tissues (muscles, fat compartments) are moved forward too. The angle between your jaw and neck has improved. This happened in your case, as well. There are lifting procedures like the Giampapa suture suspension neck lifts or other surgical neck lift techniques encompassing the anatomical structure (so-called CMAS) affecting the hyoid position. Some techniques are longer lasting than some others. Maybe some reduction of some submental fat and skin retraction with some of the non-surgical devices will already be sufficent in your case. Without a physical exam it is difficult to tell what would be your best option. Discuss your options with your plastic surgeon. I hope this answer helped a little.

Hello Nearly40FixMe. Thank you for your question regarding options for correcting an obtuse neck angle following your double jaw surgery.

Based on your history and the photos you've provided, it's clear that your primary concern is the lack of improvement in the neck-chin angle and jowls, which were key motivations for your initial surgery. Given that further jaw advancement did not yield the desired improvements and considering the alignment of your teeth, pursuing another jaw advancement is unlikely to be beneficial and may overemphasize the lower two-thirds of your face.

A neck lift is indeed a viable option to achieve a more chiseled neckline, which seems to align with your goals. This procedure would involve making an incision slightly in front of the ear, similar to those used in facelift surgeries. This allows for the re-suspension of the neckline skin, effectively tightening and refining the area to better define your jawline.

Regarding the role of a low hyoid bone in your neck’s appearance, while it can influence the neck-chin angle, the tightness you simulated with tights likely mirrors the effect that can be achieved with a neck lift rather than suggesting the need for further bone manipulation.

Surgical Considerations:

Neck Lift: This procedure would address the skin and possibly the underlying muscle layer, tightening and lifting to improve the contour and definition of your neck and jawline.
Facelift: While primarily targeting the mid to lower face, a facelift can also complement a neck lift by addressing jowls and further improving the lower face's contour.
Liposuction: This could be considered to remove any excess fat contributing to the jowls or a poorly defined jawline, although it sounds like your case might benefit more from skin repositioning and tightening.
Given your situation, I recommend consulting with a board-certified plastic surgeon who specializes in facial aesthetics. They can provide a detailed assessment and discuss how best to achieve your desired outcomes with a neck lift, possibly in combination with a facelift, based on your specific anatomical needs.

Thank you for trusting me with your concerns, and I wish you the best in achieving the results you desire.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

An in person physical exam would be necessary to say definitively but I do think a deep neck lift and/or facelift could help obtain your desired look. From the pre and post X-rays you sent it looks like your surgery was successful and probably did help your jaw and neck line aesthetics. However, a deep neck lift would allow you to sculpt underneath the platysma in order to create an even higher, tighter jaw line. I do not think your hyoid is in a poor position so that shouldn't hold you back. Hope that helps!