When is a standalone neck lift appropriate?

Thank you for your question. It covers a topic that I am frequently asked about in consultation.

There is no established answer to this so I'll explain the guidance I generally offer.

There are some aspects of the neck contouring that the facelift does not cover and viceversa, and some overlap zones.

For the neck, volume problems and platysma bands are not solved by facelift surgery. To some degree, skin laxity in the neck is improved by facelift surgery, but it depends on the extent of the facelift scars.

Laxity along the jawline and visibility of the marionette lines are not covered so well by neck lift surgery and are better addressed by facelift surgery but this is an overlap area.

Laxity for the mid-face is not covered by neck lift surgery but can be helped by facelift surgery. This is generally the forward movement of the skin around the corners of the mouth when leaning forward.

If the area around the jowl and marionette lines has moderate to significant laxity, I find that a facelift procedure, or a facelift and neck lift procedure produce more pleasing results for both female or male patients.

To get a sense of what a facelift procedure can offer, I suggest to patients to lie down completely flat and look in the mirror at the facial shape and compare it with the appearance sitting up. If they feel there is enough value to them to pursue this change, it is likely to make the facelift intervention worthwhile.

For the neck lift intervention 3D imaging and computer simulations can help to understand the potential changes. Computer simulation in 2D or 3D don't seem to work well for facelift simulations.

A final consideration is that the anterior deep plane neck lift procedure can be use for some male patients even later in life as the beard makes the skin slightly firmer.

Overall, for both men and women, regular use of sun block on the face and neck will protect the skin elasticity and provide aesthetic benefits.

There are many differences in anatomy and hairstyles in men and women, so facial surgery has to be aware of these differences. We now have great alternatives to facial surgery in those younger with radiofrequency, like Renuvion, plus liposuction if needed.

A standalone neck lift may be suitable when aging signs are predominantly present in the neck area, with minimal changes in the facial region. This procedure effectively targets issues like sagging skin, excess fat, or a 'turkey neck' appearance.

Key considerations in choosing between a facelift, neck lift, or both include:

Extent of Aging Signs: If aging signs are more pronounced in the neck with fewer changes in the face, a neck lift alone might be sufficient. If aging is significant in both areas, a combined approach may be recommended.

Patient Goals: The decision also depends on your specific aesthetic goals. If your primary concern is the appearance of your neck, a neck lift might be ideal.

Skin Quality and Elasticity: The condition and elasticity of your skin can influence the decision. Good skin quality often leads to more favorable outcomes.

Anatomical Differences Between Genders: The approach might differ slightly between male and female patients due to variations in skin thickness, hairline, beard growth, and aesthetic preferences. Men's typically thicker skin and stronger ligamentous attachments may affect surgical techniques and recovery.

Surgeon’s Expertise: Surgeons may have different approaches based on their experience. It’s crucial to discuss your concerns and expectations with your surgeon for a personalized recommendation.

In your situation, with more rapid aging changes in the neck than the lower face, a neck lift might be more appropriate. However, a detailed discussion with your plastic surgeon is essential. They can evaluate your individual case and provide a recommendation tailored to your goals and the unique aspects of male facial anatomy.

Sincerely,
Dr. Katzen