Volume redistribution – loss of volume in some areas, fat pockets in other areas
Surface characteristics – sun exposure, acne, etc.
All three of these issues are evaluated by Dr. Nichter during the consultation and recommendations are made as to which procedure or combination of procedures will provide the best outcome. Treatment may include any one or more of the following: facelift, neck lift, fat transfer or fillers, liposuction, laser resurfacing, laser tightening, chemical peel, skin care regimen.
Dr. Nichter discusses the Top 5 characteristics of the neck that he evaluates for potential improvement.
Amount of fat beneath your chin – younger patients may just need liposuction.
Platysma bands – Located in the front of the neck. Muscles that separate and present themselves as 2 bands (a.k.a Number 11 bands).
Amount of redundant skin – The amount of loose skin will determine if a surgical or non-surgical procedure is needed.
Skin quality – Skin texture, acne, age spots or sun spots, broken capillaries, volume or lack of volume, fine lines and wrinkles are all taken into consideration when assessing what treatment or procedure is necessary.
Misc. features – A prominent mandibular gland or recessed chin
Dr. Nichter talks about the people who may be a candidate for a neck lift in the video above. He states that candidates can range in age from their 20’s or 30’s up to their 80’s. Younger patients seeking neck improvement often times complain of fullness beneath their chin, which is an excess of fat, which can be removed with liposuction. If the skin doesn’t tighten from the liposuction procedure, Dr. Nichter may recommend using the Sciton® SkinTyte laser for additional neck contouring improvement. Patients who are older who are seeing the effects of aging in their neck, will often times require a combination of procedures to achieve optimal results. The procedures could be any one or more of the following: liposuction, platysmaplasty, neck lift,facelift, or laser tightening.
In the above video Dr. Nichter discusses the various types of neck lifts he offers at his Orange County practice, Pacific Center for Plastic Surgery. He also talks about the recovery following neck lift surgery and the long term expectations with scarring.
Best Neck Line Improvement Requires Best Neck Lift Options and Best Plastic Surgeon
Neck Lift is a general term relating to procedures that will improve your neckline. There are many possibilities so picking the best neck lift treatment(s) for optimal improvement is most important. A board certified plastic surgeon with a special interest and substantial experience in neck lift and lower face lift surgery is the place to start. The reason for a plastic surgeon is that he/she can offer all possible options and tell you specifically which ones are best for you. Click here for tips on finding the best plastic surgeon.
The best recommendations to improve your neck appearance depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:
Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle.
Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.
Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.
Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.
Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.
In summary, picking the most qualified and best plastic surgeon with the most experience in neck improvement is essential to ensuring that you will have a wonderful and lasting result. It is the plastic surgeon’s ability to evaluate both your anatomical features and aesthetic goals to guide you to one or more neck lift procedures to give you the best neck line possible.