What is banding of the neck? Is it different from droopy skin? Can neck surgery avoid having scars in front of the ears? (photo)

I have drooping, loose neck skin. I don't believe luposuction would be helpful unless it tightens up the jowls.

Doctor Answers 11

Banding of the neck

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The neck banding is due to laxity partially in the skin but mostly in the plastysma muscle under the skin. This muscle tends to develop laxity as we age and may also separate, causing vertical banding as in your photographs. You are correct that liposuction is not usually the answer, and the skin and muscle layers under the skin need to be tightened in order to see any real improvement. 

With regard to scars around the ears, there are many different options. The scars can be very well-hidden around the ears so that they are not noticeable. There are also options to place incisions under the chin or directly in the central portion of the neck, but most patients opt for the incision around the ears due to how well they hide.

An in-person consultation with an expert for an exam and to discuss all of your options regarding different techniques and placement of incisions would be very helpful.

All the best,

Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

What is banding of the neck? Is it different from droopy skin? Can neck surgery avoid having scars in front of the ears? (photo)

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The banding in your neck is from your platysma muscle that has loosened and separated. This is something that can be corrected with a lower face and neck lift. Unfortunately, it is not preferred to only address the neck with incisions behind the ears, because there is not enough strength to have a long lasting effect, nor does it address contributors to your neck issues, like the jowls and loose skin at the jawline.  A lower face and neck lift is performed at the same time. The incisions in front of the ear should follow the curvature of your ear and come up from under the lobe to the back where it is hidden. There is also a small incision just beneath the shadow of the chin. These incisions are key for access to suspend the tissues from underneath the skin, back to where they used to be. Those tissues are your jowls and should be addressed as well. Fixing the platysma bands in the neck can be done from the incision under the chin, but sometimes may need the access point from behind the ear. That would need to be clarified by your surgeon.This approach will rejuvenate the key areas of aging that I see in your photos. Always seek advice from a plastic surgeon certified by the American Board of Plastic Surgery.Good luck!

Reza Rod, MD
Phoenix Plastic Surgeon
4.6 out of 5 stars 8 reviews

Face rejuvination procedure

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Thank you for your question and helpful photos. You are correct in determining that liposuction alone will not be helpful. I'm afraid that an incision in front of the ears is unavoidable in your case to address your concerns. But not to worry. If executed well, an incision in front of the ears is hardly noticeable once it heals. You may take a look at my gallery to see how well incisions heal in front of the ears. Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Loose neck skin and banding can be improved with a mini neck lift with or without a mini facelift

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We have been able to achieve very nice results with a mini neck lift for loose neck skin and banding. This procedure includes laser collagen stimulation & liposculpting, platysmaplasty( tightening of the "slouchy hammock") and lifting of the neck tissues.  the incision for this would be in the chin crease and also behind the ear.  It is true that the jawline and neck are best treated together with additional incision in front of the ear but this is not mandatory.

Ritu Malhotra, MD
Cleveland Facial Plastic Surgeon
4.6 out of 5 stars 10 reviews

Neck Lift

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Thank you for your question. You are an ideal candidate for the laser-assisted weekend necklift. With a small incision under the chin and a tiny incision behind each of the ears, I utilize liposculpture, neck lifting and laser resurfacing to restore a more youthful look to the neck and jawline. Liposculpture will remove any excess fat. Afterwards, surgical lifting and gentle tightening of the underIying muscle tissues of the neck will hide your scarring and create an improved aesthetic. Laser resurfacing is performed through laser rejuvenation technology, one of the most cutting edge procedures available. The best part of the procedure is that patients are able to resume their usual activities in less than a week, hence the name "Weekend Necklift." I suggest that you consult with a board certified facial plastic surgeon.Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Facial Aging and Lasers like Fraxel/Clear + Brilliant, RF like VIVA, Peels, Fillers, Skin Care, Face Lift, Fat Injections

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you have loose skin and lost skin elasticity, this needs treatment with skin removal/neck/face lifting, lasers, sculptra/filler injections.  A combination approach is best.  Neck bands can be improved with botox and muscle tightening (platysmaplasty).  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Loose skin and muscle on the face as well

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Your neck would need work on the platysma muscle as well as a facelift. Because you have looseness on your lower face as well, it's best if you also had a facelift as well as addressing the neck.  Results would be best if incisions in front of the ear were considered for your procedure.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

Lower face and neck lift is effective for jowls, sagging skin, & neck banding

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Hi Renamaeshella.  Thanks for sharing photos with your question. Banding occurs from the underlying platysma muscle and loose skin-this may require an incision under the chin as well as behind the ears.  The incision in front of the ear is the best for correcting jowls, sagging corners of the mouth and cheek area-when placed precisely around the earlobe and along the shape of the ear, they are barely visible.  Liposuction will not help unless there is excess fat, which doesn't appear to be the case for you.  You appear to be a good candidate for a lower face & neck lift.  And don't forget about some skin rejuvenation to help with the fine lines, wrinkles, pigmentation, texture, etc. that is not treated with surgery alone-you may have a CO2 laser resurfacing or Profound radiofrequency microneedling for maximum improvement.  If you have some time before surgery, see a medical aesthetician in your PS's office for suggestions on medical grade skin care products, chemical peels, etc.  Best wishes,

What is banding of the neck? Is it different from droopy skin? Can neck surgery avoid having scars in front of the ears?

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Hello Renamaesheila - Thanks for your question. Banding of the neck is the result of laxity in the platysma muscle.  This muscle is typically repaired in face and neck lift procedures. Banding of the neck is different from droopy skin, but they look the same and are often seen together.  In a neck left, the incisions are typically just under the chin and behind each ear.  If there is a lot of excess skin, a small incision might be necessary at the front of each earlobe to allow better redrape of the skin after removal of the excess skin.  Over the last 7 years I've been developing a procedure known as the Ultralift.  An Ultralift Level 3 is designed to tighten the neck without incisions in front of the ear.  Also, check out my web link below of a recent Ultralift Level 3 I performed in the office.  Good luck, Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

What is banding of the neck?

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Thanks for including such good photos. They show significant skin laxity with little fat deposition so only  a skin tightening procedure would be indicated. Because of the aging changes throughout the face you would do best with a full face and neck lift. It would look pretty bad to have a tight neck and loose face. The scars do go in front of the ears but are basically invisible after about 4 months if done by a skillful surgeon. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.