What procedure would help me best? I am very bothered by looseness in the neck and the bands it creates. Thank you. (photo)

I was thinking lower face lift or liposuction of the neck. I am 55.

Doctor Answers 13

Loose Bands

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Hi Lolly909

Many thanks for your post.

For those who have excess fat under the chin but still have good muscle tone and skin, liposuction of the neck will be sufficient. If the skin has lost elasticity, removal of excess skin (Neck Lift Surgery) to tighten and tone the neck will also be required. Tightening of the platysma muscle (also known as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscles on the neck; they are sutured together with permanent stitches. The muscles of the neck are the foundations and building blocks of the neck and are fundamental to achieving a tight and toned result.

You have a couple of options, so seek out a qualified and experienced surgeon to talk through what is realistically achievable.

Neck looseness and bands

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Thank you for asking about your lower face lift.

  • In addition to the neck fullness and loose skin and bands, you have slight jowling as well.
  • A lower face and neck lift, with liposuction of the neck and release of the bands is likely to be your best procedure.
  • Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

What procedure would help me best? I am very bothered by looseness in the neck

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties with early "jowl" formation.  From the limited photo, your chin is weak and there is excess fat below the chin.  Non smiling photos of your face from the front and side would help in the evaluation for a lower facelift.

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Facial and neck rejuvenation

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Based on this photo (that doesn't show much) you seem to be a candidate for face and neck lift with aggressive neck fat removal. You should seek a consultation with a board certified plastic surgeon with extensive experience in facial rejuvenation (face/neck lift) for detailed clinical evaluation and discuss your option. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 22 reviews

Lower facelift

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Thank you for your question and photo. 
Lower facelift means different things to individual surgeons. In general it usually means to address the neck and jawline. From the single photo you have sent it looks like you have some mid face changes as well including descent of the tissues with volume loss. A more complete facelift would be indicated in this case. With a single view its difficult to give you a complete analysis and a formal, thorough consultation by a board certified plastic surgeon is definitely indicated. This would allow you to review your concerns and the best technique to address you findings
Best of Luck
Dr G

Lee A. Gibstein, MD
Miami Plastic Surgeon

Lift Options for the Lower Face

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A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.
During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.
If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.
Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lower facelift with lipo

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Thanks for sharing.  Looking at your photo you are correct in what you may need.  Actually, both a lower facelift with liposuction would give you optimal results.  Consult in person with a specialist to get definitive recommendation. Best of luck!

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 reviews

Neck Liposuction and Bands

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Hello, and thank you for sharing. I do think you are on the right track as far as which procedure would be best for you. Certainly liposuction under the chin and jawline will help decrease the fullness you do not like. I'm curious as to the "bands" you are referring to. Traditional "bands" in the discussion of neck aging usually refers to the "vertical" bands of muscle (platysma) that some patients develop (typically there are two that you can see about a half inch off midline on both sides). Perhaps you are referring to the horizontal bands (or lines) in the skin (creating a crease). If these are your concern, most neck lifts (with or without lipo) will not significantly improve them. The most common practice is to fill those horizontal lines with a filler such as juvederm. When you do consult with a PS, be sure to be very specific as to what bothers you so that he/she can recommend the appropriate treatment(s). Best of luck to you!

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 78 reviews

Face/ Neck Lift

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For a 55 year old patient with the findings seen in the photo, a face/neck lift, aka lower facelift would be the most beneficial, longest lasting, and most effective procedure.  Of course, more important than the choice of procedure is the Surgeon performing it. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

What procedure would help me best? I am very bothered by looseness in the neck and the bands it creates.

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Thank you for your question.  It's hard to tell based on the photo provided.  However, a lower facelift / neck lift would eliminate the loose skin and bands of the neck, sharpen the jawline, and eliminate the jowling.  Liposuction can be added to eliminate excess fat.  Be sure to consult with an experienced plastic surgeon certified by the American Board of Plastic Surgery.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

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