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

Question

6 months post double jaw surgery, I've noticed no improvement in my neck-chin angle or jowls. A key concern and motivation for the surgery. Possibly due to being older than the typical patient. Using tights, I simulated a desired tighter and better neck to chin angle. Could a neck lift, facelift, and lipo help achieve this look, or might further jaw advancement be necessary? I'm wondering if a low hyoid bone is factor but but I’m curious if improvement with tights simulates a neck lift

Bianca Knoll, MD · Answer

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.

J. Timothy Katzen, MD, FACS · Answer

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

P. Alex Montague, MD · Answer

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!

Lucian Ion, FRCS · Answer

Thank you for your enquiry, insightful comments and sharing your photographs.

3D imaging and computer simulation can guide you to understand whether you could obtain the change that you seek just with volume reduction (anterior necklift) or whether skin tightening would also be necessary.

Skin tightening in the form of a formal necklift or a combination of facelift and necklift can be considered but the primary element that would give you the changes you describe is sub- platysma volume reduction. This is carried out through an access incision under the chin and represents the deep plane neck contouring approach.

William Portuese, MD · Answer

From the photographs presented, you could have fat deposits located both above and below your platysma muscle in your neck. A neck lift can accomplish removal of The Fat deposits above the muscle with liposuction, surgical extraction of the fact below the muscle, and a platysma plasty to significantly improve your jawline. The position of your hyoid bone is irrelevant. If you have loose and inelastic skin in your neck, then you're going to need a lower face and neck lift.

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

Answers (5)

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