Can a neck lift be done without cutting under the chin? (Photos)

Question

Doctors where very kind on RealSelf to advice me that neck lift will give me the best results, so I decided to have the surgery, rather than laser. My doctor is doing it under general anesthesia. He told me that he doesn't cut under chin, that he only cuts at ears and lifts the skin from there. Will it give me as good of a result as cutting under chin and ears? I am having my breast implant correction and neck lift same time, that's why I am going to the same doctor who did my breast implant.

Jed H. Horowitz, MD, FACS · Answer

A necklift is not a singular procedure with a singular #method, but rather is an umbrella term describing a large range of operations with varying #incisions and skin-lifting #techniques, which have been developed and improved upon over the years.  Your board certified plastic surgeon will be familiar will be able to pair you with your perfect match of surgical approach based on your skin type and desired results.  The type of necklift incision will depend upon your gender, your hairline and preferred hairstyles, any scars from previous surgeries, and a variety of other factors.  As a general rule, a #necklift #incision starts right in front of or within the hairline on the temple, follows the curve of the front of the ear, travels underneath the earlobe, and ends at the hairline behind the ear.  There are also shorter #scar techniques preferred by many patients, which do not have incisions in the hairline.  Some patients who wish to have liposuction or tightening of their neck will need an additional incision under their #chin, which can be hidden in a natural skin fold.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Yes. The laser-assisted weekend necklift makes a small incision underneath the chin and a tiny incision behind each of the ears for surgical lifting and gentle tightening of the underlying muscle tissues of the neck. The procedure is much less invasive than the conventional facelift and offers a short recovery horizon. Alwawys work with board certified facial plastic surgeon.
Best wishes,

Mark Karolak, DO, FAOCO · Answer

In a midline neck lift (aka platysmaplasty), the incision is placed under the chin. Skin is usually not removed. Muscle bands are sutured back together. 
In a lateral neck lift, the incisions are placed in the crease in front of the earlobe and extend behind the ear and along the hairline. If only skin is pulled without tightening the muscles first, the results will not last very long. Muscles should be pulled laterally and excess skin is then removed. In this approach, although the neck will look better and the results will last, the muscle bands in the middle of the neck will reappear in 3-6 months. 
More commonly, a combined approach using both techniques is performed, which is a "full" neck lift. When looking at your neck, it seems that you will have a nice result with the lateral neck lift, but even a better result with the combined approach. Every surgeon will have a different opinion. What works for one surgeon may not work for another. Since you have researched your surgeon and feel confident in his or her skill, it is very likely that based on his or her examination of your neck, the approach that has been chosen is one that her or she feels will achieve the results and goals you have discussed.

Raymond E. Lee, MD · Answer

Good question. I have performed thousands of lifts with and without the incision under the chin and I do believe when warranted the added chin incision allow for better results. The incision under the chin allows for chin lipo and a platysmaplasty (tightening of the neck "turkey bands" muscle).  I do see the bands on your lateral view. You will have a better neck with a lower facelift but an even superior result with an added incision under the chin to perform the above.

Parker A. Velargo, MD, FACS · Answer

While most surgeons routinely perform a neck lift with both a submental incision (under the chin) and postauricular incision (behind the ears), it IS possible to lift the neck in a stable and lasting manner using ONLY the postauricular approach.  In a patient, like yourself, with minimal to no submental fat and visible banding of your platysma muscle, that muscle needs to be addressed in some way.  Most surgeons address this muscle through the submental approach -- sewing the bands together in the midline.  The muscle is then lifted and tightened from the postauricular approach as well.  Some surgeons say that by tightening the muscle in the middle it limits the amount of tightening that can be accomplished from behind the ears.  In any case, there are numerous ways to address the platysma, and there is no one-size-fits-all treatment.  One way to lift the neck without a submental incision is by accessing the neck muscle (platysma) from the postauricular incision, cutting across the platysma (partially or completely) through the banding in the middle, securing the muscle remnants to the fascia behind the ear, and then re-draping and removing the excess skin.  There are multiple other ways to do this as well.  Really it all comes down to the technique(s) that your surgeon is (are) comfortable with and whether you like the results you have seen in his/ her before and after photographs.  Visit with an experienced board certified facial plastic surgeon or plastic surgeon for a second opinion if you have doubts.  Otherwise, good luck moving forward and rest assured that it is possible to get a good result without the submental incision if executed properly.

Brian K. Machida, MD, FACS · Answer

In general, I perform incisions under the chin to address the platysma directly in addition to incisions on the sides. I find that by doing so, the results are improved.  You might want to consider seeking consultation from other doctors in your area before embarking on a neck lift with your breast implant revision to make sure that you will be satisfied.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may
benefit from a mini facelift with a neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Some surgeons perform a submental incision and some do not.  You should have a nice result.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Tanveer Janjua, MD · Answer

Thermitight is a non surgical procedure to achieve the necklift effect. RegardsDr.Janjua

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures.  Yes, a neck lift which targets the SMAS muscle and skin can create a smooth neck line.  An incision is made under the chin when neck liposuction or platysmaplasty surgery is begin performed.  These are not always needed.   Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best

Michael I. Echavez, MD · Answer

A neck lift can be done without cutting under the chin.  Sometimes an incision is used under the chin if some fat in the neck is going to be removed with liposuction or if some suturing of the platysma muscle to tighten it is going to be done.  These procedures are not always needed in a neck lift.

Can a neck lift be done without cutting under the chin? (Photos)

Answers (15)

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