Question: I’m 55 years old with the face of a 45-year- old but the neck of a 70-year-old. When I cover my neck I look so much younger. I can only use a scarf to do this though, because a turtleneck emphasizes my gobbler. I don’t know if a facelift could help this or not. Is there anything that can be done? A scarf in 90º weather is torture!!
Answer: The neck is every bit as important as the face when it comes to gaining a rejuvenated appearance. It’s not that unusual to see an older Hollywood star with a face beautiful for their age, hiding their neck behind scarves or in clothing. Once jowls begin to appear, it is a sign that the skin from the face, jaw and chin are beginning to loosen. People assume that all they need is a facelift when this happens, when in reality what is often needed is both a face and necklift. If the neck is overlooked, or poorly done, the entire facial surgery can be a waste of time and money. In most cases a necklift and facelift go hand in hand.
Although it is possible that some patients may only need a necklift, it is more often the case that procedures such as a chin implant or a facelift are made complete with the addition of the necklift. A good surgeon that is capable of performing one will address both areas and discuss options with their patients.
The key to a natural necklift is in addressing the multiple directions that the muscle and skin must be tightened for a smooth transition from the neck to the face. The directions of tightening for a natural necklift are called vectors. The fat of the neck needs to be sculpted with liposuction and the thin muscle of the neck (the platysma), needs to be tightened so as to smooth the bands of the neck which become evident with aging. It is also important to lift the neck low enough to allow complete exposure in clothing and for jewelry. Everyone is familiar with the very harsh, “I’ve had plastic surgery” look that comes with a procedure not done properly; this illustrates the importance of choosing a plastic surgeon who is experienced in doing this procedure. The best way to do this is to ask how many a surgeon has performed and to see multiple before-and- after photos.
A few younger patients may benefit from liposuction of the submental (under the chin) area also referred to as a waddle. These patients do not have concerns about their jowls or skin laxity. Submental liposuction, with the addition
of a chin implant, if needed, can result in a dramatic improvement that will last for years. It is important to consult with a plastic surgeon that will listen to your concerns and address them honestly. You may or may not require a more extensive procedure, and you certainly would not want to pay for a lesser procedure and be unhappy with it. This is where choosing the right surgeon is most important.