The Surgeon Minute

Surgical & Non-Surgical Neck Lift

Surgical & Non-Surgical Neck Lift

The neck has become a hot topic for men and women starting as early at their late 20’s. Part of this is thanks to the “age of the selfie,” although Facetime and Skype have certainly played their part, too. The reality is that most of us are looking at our necks every day, often at an angle that doesn’t do anyone any favors.

Thankfully, there are both surgical and non-surgical options for treating an aging neck. Dr. Richard Zienowicz of Providence, RI discusses the pros and cons of his favorite techniques for treating a neck that’s no longer making you look as young as you feel.

Surgical and Non-Surgical Neck Lift

A neck lift can be an ideal bridge for patients between their 30’s and 40’s and even their 50’s and 60’s who are “trying to prolong the inevitable, which is a facelift,” explains Dr. Zienowicz. “A facelift attacks the neck in the most direct fashion so you can really tighten up the skin optimally,” but there are patients who just aren’t candidates for a facelift for any number of reasons, such as:

  • They can’t afford the downtime necessary for surgery.
  • They don’t want to deal with scars.
  • Financially, a facelift is out of their budget.
  • They are frightened of having surgery.
  • Surgery isn’t an option health-wise.

For these patients, the new non-surgical injectable called Kybella might be one solution. Kybella is the only FDA approved injectable for treating the fat under the chin, which is a huge trouble spot for so many women and men. It’s particularly effective for patients who have what’s called an obtuse cervical mental angle, where the angle from the chin down to the sternum is more of a straight line than a right angle.

Kybella for a neck lift.

This lack of definition is incredibly aging. When injected at regular intervals over a period of time, Kybella kills the fat cells. As the fat cells die off, the patient will begin to see a hollowing out of this under chin/upper neck region. The good news is that Kybella permanently eliminates the targeted fat cells. The not so good news is that it requires multiple injections and is “quite expensive when you come right down to it,” says Dr. Zienowicz. However, it, along with another popular and effective non-surgical fat removal option, CoolSculpting, are great options for patients who can not tolerate the idea of going under anesthesia and having an incision.

For those patients who are not adverse to surgery, liposuction is still the gold standard for most surgeons when it comes to fat removal. For liposuction of the neck, surgeon typically make a tiny incision under the chin through which he the fat can be removed. It “immediately produces a dramatic effect,” unlike Kybella or CoolSculpting which can take months to fully resolve.

If the fat is also below the muscle, and the patient has banding of the platysma muscles (the vertical muscles that run down the front of the neck) then an incision can be made under the chin, the fat is removed from both above and below the platysma muscle, and then the muscle tightened in a procedure that’s know as a corset platysmaplasty or neck lift.

Neck lift before and after.

Different Approach for Men & Women

Men and women require slightly different approaches when it comes to a neck lift due to both their lifestyle and anatomy. “We want to avoid scars on women at all costs” explains Zienowicz. For men, scars don’t seem to be as a big of a deal. Part of the reason for this is that men’s skin is a different texture than women’s skin. It tends to be thicker and therefore doesn’t scar quite as easily.

Men often also have beards which can conceal a lot of scarring. It makes then ideal candidates for the neck lift than goes through an incision under the chin as opposed to behind the ears. This is also the best technique for men who have short hair or are bald. Women can better tolerate a neck lift where the incisions are behind the ears since they typically have long hair which camouflages the incisions.

With any of the surgical neck lift techniques, the result is a defined, youthful looking neck that will immediately take 10-15 years off a patient’s face. Needless to say, patient satisfaction with a surgical neck lift is very high.

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