A gracious neck is defined as having a sharp angle between the jaw and neck, smooth skin, and no muscular bands showing. However, genetics predetermines in youth the overall shape of everyone's neck. Some of us have a very high and tucked voice box, which showcases the thin, long neck. Others have a fuller, shorter neck with a voice box which is low-slung and forward.
Surgery cannot correct the original shape of the neck that you were born with, but it can address the three factors of aging: fatty accumulation in the neck, loosening of the neck muscles, and excess skin in the neck. If you are interested in a neck lift, the team at our Minneapolis-St. Paul-area practice can answer any questions you may have.
Facial liposuction can selectively remove fat from the neck. The i-Guide suture-suspension system can add support to the muscles of the neck, and an open procedure is necessary when the aging of the neck is more advanced. An isolated neck lift is indicated only for early signs of aging, or when a previous facelift has already been performed.
In young people, there may be early relaxation of the supporting structures of the neck combined with fatty accumulation. Very frequently, the chin prominence may be weak. Facial liposuction alone may be of benefit, and the minimal excess of skin created will retract. This result should maintain for several years and may be even more enduring if a chin implant is added if needed. Facial liposuction is minimally invasive, in that it can be performed through small stab incisions made behind the earlobes and under the chin.
Swelling and bruising is usually minimal, and an elastic garment is used for the first several days to keep the skin tight against the jaw and give the best curvature possible. Facial liposuction is also an adjunctive procedure frequently performed during a facelift to remove isolated pockets of excess fat.
i-Guide Suture-Suspension Neck Lift
The i-Guide Surgical Suture System is an FDA-approved system which adds structural support under the neck using permanent sutures. This unique system allows Dr. Szachowicz to elevate and define the contour of the neck by weaving a criss-cross suture beneath the jaw-line. The system works through small puncture wounds through which a trampoline-like structure is woven to provide a low-tension support to the neck, elevating the skin and muscle as one unit.
The system works to replace the weakening of the support system of the front of the neck. The procedure is combined with facial liposuction, and is performed under local anesthesia. Swelling resolves within a week and has much less downtime than a traditional open neck procedure. This procedure works best in people who have lost the contour in the neck but still have good skin elasticity.
Open Neck Lift with Tightening of the Muscles
The best candidates for an open neck-lift are those whose thinner necks are showing the earliest signs of aging and muscle-banding. Also, people who have had a previous facelift and only see age-related changes in the neck may opt for an open neck-lift. The goal of this procedure is to tighten the neck-bands one to the other in the front of the neck, and then pull the muscle tight behind the ears, where excess skin can be removed. This is not a procedure for when there is jowling or relaxation in the face, as this will accentuate the facial relaxation.
The procedure can be performed under local anesthesia as follows:
- An incision is made below the chin, and the skin is separated off the underlying muscles (platysma muscles)
- The fronts of the muscle-bands are sutured together, tighter under the chin, to create a “hammock-like” tightening effect
- Then incisions are made starting at the earlobes, going behind the ear and then along the hairline at the back of the neck
- The skin is then elevated and connected to the front part of the neck to re-drape the skin over the muscles of the neck
- Excess skin is removed from behind the ear as the wound is closed
An elastic garment is worn for one week to maintain the contour of the neck. Swelling in usually resolved in a week, and remaining bruising can easily be camouflaged with makeup. The incisions do not alter the hairline. As with any open procedure, the risks are of blood collecting under the skin, infection, and (rarely) damage to sensory or motor nerves.
Direct Neck Lift (Z-Plasty of the Neck)
A direct neck-lift or Z-plasty is a procedure reserved for the most advanced excesses of skin and muscle, called a "turkey gobbler." This usually occurs in those of advanced age who are not the best candidates for a more involved facelift. The procedure involves direct excision of the excess skin from the front of the neck and tightening of the muscles of the neck before the skin is closed. A visible scar is unavoidable after the surgery, but is much preferred to the hanging excess skin.
The procedure is performed under local anesthesia as follows:
- The excess skin is marked when the person is standing
- The excess skin is removed, and the underlying muscle is tightened to form a muscular supportive sling
- The incision is closed in a zig-zag fashion to align in the creases of the neck
A supporting garment is worn for one week. A series of Fraxel laser resurfacing treatments are performed to optimize the healing of the visible scar. The risks of damage to nerves are lessened with this procedure. In older individuals the wounds may take longer to heal.
Learn More about Your Options for a Neck Lift
If you live in the Minneapolis-St. Paul area and are considering a neck lift or any surgery for facial rejuvenation, contact Dr. Szachowicz's Edina, Minnesota office today. With video-imaging you can simulate a neck lift or any other facial procedure.