Gravity is the most important cause of drooping of the skin. Genetic factors or repeated weight changes (yo-yo effect) cause our skin to sag over time. The sagging results in a downwards movement in facial features of frontal and mid areas. As for the lower facial and neck areas, excess skin results in deformation of the face shape; we call this phenomenon deformation of oval of the face. The angle between the submental area and the neck is flattened, resulting in an aged appearance, especially from the profile. This condition may be accompanied by fat accumulation under the chin, called double chin or turkey neck.
Liposuction (suction-assisted fat removal) can treat fat accumulation in the neck in cases where the patient is young and the skin is firm. Patient’s choice and surgeon’s experience is very important, as the neck skin is thinner than the facial skin, making it prone to sagging when the fat underneath is removed. From my experience, men are luckier than women as their skin is thicker than women’s, they can tolerate liposuction better. To treat excess skin after a liposuction surgery, even younger patients who suffer from excessive fat tissue under the chin must be considered for simultaneous neck lift surgery.
Neck lift surgery is generally done as a follow-up to facelift surgery. Occasionally, the aging issue of the face is concentrated in the lower part of the face, a neck lift surgery is then scheduled.
When planned correctly, neck lift is one of the plastic surgery procedures where concealing the scars is easiest. In my own technique, I do not prefer incisions in front of the ears. I start the incision in the inner direction of the ear canal, continuing around the earlobe directly behind the ear, making it possible to conceal the scars even during the first days. To make the neck lift surgery more effective and its results last longer, I remodel loose neck muscles and their fasciae underneath the skin towards the back of the ear with small suture suspensions, serving as a corset for the neck. Following which the excess skin is removed and the skin is closed with absorbable sutures that won’t be taken out. A drain is placed behind the ear, it will be removed the next day.
In the event the platysma bands (starting from under the chin going downwards) are prominent, they are loosened with a 2-3 cm incision directly under the chin, the superficial muscles that spread away from each other are reunited in midline (platysmaplasty), giving the neck elasticity along with a perfect contour.
The use of cigarettes, aspirin and Vitamin E should be limited for 10 days before the neck lift surgery. The operation is performed in hospital environment, under general anesthesia or local anesthesia accompanied by sedation. Minimal pain may occur after the surgery, some patients will experience a slight stretching. The special dressing / chin strap or corset that is put on after the surgery should be worn until the follow-up consultation, 4-5 days later. A one night stay in the hospital is appropriate, as the drains will be removed the next day.
The return to work and social life is possible one week following the neck lift surgery.
The result of the operation and its durability depends on the technique used. Results of operations consisting only of skin lift are generally far from natural. The technique I use, called “corset platysmaplasty” is an aesthetically superior technique the effects of which may last, depending on the patient’s skin type, at least for 10 years and sometimes a lifetime.