Why is it necessary to do a Z incision below the chin when performing the neck lift?

What kind of incisions are made with a neck lift? When is a Z shape incision made. Is a partial facelift with a neck lift preferable to result in less visible scarring?

Doctor Answers 10

Neck lift scar

The Z is not used by many especially on females due to the scar. As stated by others the ear and small under the chin incision are the usual ways to go. I would be worried if this was offered to you as a first choice. please see a board certified plastic surgeon, Good Luck!

Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Neck lift incisions

There are 3 incisions for the neck lift and are all approximately 1 inch long. The first is in the sub-mental crease below the chin and the other 2 are in the post auricular crease behind the ear. A Z-plasty is not required for neck lift. If there is excess skin in the front portion of the neck, then a lower face and neck lift will be required. For many examples of neck lifting and facelifting results, please see the link below to our photo galleries

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Z incisions are not necessary with neck lifts.

Contouring the neck is best accomplished by elevating the skin and some of the underlying fat from the neck, defatting the areas of excess fat, contouring the platysma muscle with midline sutures and lifting/tightening the platysma muscle laterally by the ear, then advancing the neck and facial skin superiorly and posteriorly to remove the excess. Incisions on the anterior part of the neck leave unacceptable scars which are poorly hidden while the scars by the ear are very well hidden. Neck contour is the result of the proper contour of the structures deep to the skin, not by pulling harder or resecting midline skin.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 98 reviews

Neck lifts can be done mainly 2 ways.

Neck lifts can be where an incision is made under the chin and the skin is pulled toward the under chin area for roughly $5500 which works great in men. The other method is pulling the skin backwards toward the ears and is part of a facelift procedure for roughly $9000 and works great for women since their hair covers the incisions. Sometimes you may need both. Either can be done under local anesthesia and easy to undergo. Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Necklift incision questions

A necklift can often be done with an incision in the crease under the chin and/ or around the ears. If an incision does need to be made from the chin into the lower portion of the neck, a "Z" is often created to prevent a tight scar band from forming. The "Z" actually lengthens that incision to prevent it from becoming too tight. This scar typically heals very nicely when properly placed and carefully closed.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Z Incisions Aren't Necessary

The short answer: It is not necessary. There are a number of techniques for performing a neck lift, including avoiding an incision behind the ears, simply resecting excess skin, removing fat, and tightening deeper tissues through an incision beneath the chin. However, if there is sufficient looseness of skin, it must be tightened either by resecting skin behind the ears, or through a Z incision. That scar is somewhat visible and does not always heal in a graceful, minimally visible way, so it is appropriate to be cautious and fully informed before agreeing to that approach. Incisions around the ears involve more freeing up of tissue — and more surgery — but the incisions can be completely hidden and allow more flexibility in correcting the relaxed tissues. Talk to your surgeon about these options.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 95 reviews

Why is it necessary to do a Z incision below the chin when performing the neck lift?

The lower face and neck lift will not require a Z incision.

Find a plastic surgeon with ELITE credentials who performs hundreds of facelifts, necklifts facelift revisions, and facial procedures each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. 

Kenneth Hughes, MD 

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

A Z incision is not usually required for a neck lift.

Thank you for your question. In my experience almost all neck lift procedures can be accomplished and produce a good result with a small incision beneath the chin and incisions behind and around the ear.

It is unusual to need a Z incision however this can be done in extreme cases of skin laxity on the neck.

It is not necessary to do a Z incision below the chin when performing a neck lift.

It is not necessary to do a Z incision below the chin when performing a neck lift. 435 years and thousands of facelifts I've never had to do a Z incision on the neck while performing a facelift for necklace. See a very experienced facelift surgeon for any further questions you have.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Neck lift and "Z" incision

A "Z" incision is absolutely not necessary and leaves a prominent scar on the neck like "Zorro" would do. Some patients who are not very healthy opt for this approach because it is quicker.

Steven Wallach, MD
New York Plastic Surgeon
4.1 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.