How to Choose the Right Neck Lift Procedure

While in most cases, the face and neck are treated at the same time, often in conjunction with liposuction to sculpt the area beneath the chin and jawline, younger patients with fatty necks but no significant facial aging may be treated with neck contouring alone. This can involve two different procedures: platysmaplasty (which addresses the “turkey wattle” or neck “bands” problem) and cervicoplasty (which removes excess skin).

Excess subcutaneous (beneath the skin) fat is removed via liposuction, while fat between and below the platysma muscles (long muscle bands that stretches from the jaw bones on both sides of the neck to the pectoral muscle) will require a deep plane procedure. Your surgeon can explain which method is appropriate for your situation. If needed, your surgeon can also correct an inadequate chin projection (a “weak” chin) with a chin implant.

Another option, notes WebMD, is Botox injections, which relax parts of the platysma causing the “band” appearance or look of fullness. These are performed on an outpatient basis and typically can be completed within 15 minutes. Or, if you want only noticeable but modest improvement, you might want to consider tissue tightening, during which the skin receives medium to deep heating which then causes immediate collagen contraction and new collagen production over a 4 to 6 month period. Although it’s a non-invasive procedure, it can be somewhat uncomfortable during the treatment.

How a Neck Lift is Done

There are four options for neck rejuvenation:

• Liposuction
• Submental neck lift
• Short-scar face and neck lift
• Full-scar face and neck lift

The best candidates for liposuction recontouring of the neck are younger patients with normal-quality skin and localized excess submental (beneath the chin) fat. The surgeon will make a small incision under the chin to remove the excess fact, using either ultrasound assisted lipoplasty (UAL) or suction-assisted liposuction (SAL). The surgeon will then close the incision, and use foam tape or an elastic garment for postoperative compression.

A submental neck lift, sometimes called a “corset platysmaplasty,” involves making a 3 to 5 cm incision just behind the submental  crease. Your surgeon then removes the subcutaneous fat as well as any fat on the platysma and between the platysma muscle, followed by a muscle reduction if needed. The surgeon will then close the incision and apply tapes and dressings.

A short-scar face and neck lift is a good choice for patients with jowls and neck and face aging but without excess neck skin. Your surgeon will make an incision in front of your hairline below the sideburn and another down and around the earlobe and into the neck. If needed, jowl correction can be done by trimming excess fat, repositioning the jowl fat at a higher level, disguising the jowl by injecting more fat along the jawline, or a combination of these procedures. Once the excess muscle is removed, the surgeon will close your incision.

The fourth option — full-scar face and neck lift — are used on patients with aging changes of the face and neck, combined with inelastic and excess neck skin. Similar to the short-scar face and neck lift, the incision begins in front of your hairline below the sideburn, continues around the back of the earlobe up to the level of the tragus (the fleshy projection just in front of the opening to your ear) or higher, and follows the hairline along the back of the head. After removing any excess skin and the neck muscle, the surgeon will close the skin incision, and apply a compression bandage, tapes and dressings. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

Anesthesia is usually based on your level of comfort and desires. WebMD recommends discussing the type of anesthesia to use with your surgeon. Your surgeon will provide you with specific instructions to follow prior to your neck lift. The day of your neck lift, wear comfortable clothes, including a shirt that opens in the front, to avoid having to pull it over your neck and head.

What is the Recovery Period

When your procedure is completed, you will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon. Also, plan to take at least one week off from work to recover.

If you are undergoing either neck lift (platysmaplasty, cervicoplasty) or a combination of any of the procedures, WebMD recommends setting up a home recovery area with the following:

• ice packs, gauze and towels, and a thermometer
• comfortable, loose clothing with tops that open in the front
• petroleum jelly and antibacterial ointment for incision sites
• a telephone nearby
• pillows to keep your head in a comfortable position.

You should also have someone who can stay with you at least the first 24 hours after surgery.

According to the Cleveland Clinic, the results of a neck lift procedure are visible almost immediately, although it may take several months for all subtle swelling to subside.[1]

 

What Will It Cost?

Generally speaking, insurance does not cover cosmetic surgery, although if the procedure corrects or improves a genetic deformity or traumatic injury, it may be reimbursable in whole or in part. Be sure to check with your insurance carrier for information on the degree of coverage.

Since neck lifts have traditionally been part and parcel of a face lift, according to the American Society for Aesthetic Plastic Surgery (ASAPS), it’s difficult to separate out the cost of the procedure, the average fee at $6,850.

If you have health insurance, the Healthcare Blue Book recommends asking in-network providers what their fee is for this service, since rates can vary even among in-network providers. No health insurance? When asking about fees, ask the providers if they offer discounts for self-pay patients. And don’t forget to ask about financing plans, since many plastic surgeons offer that option.

Since cosmetic or plastic surgery can affect premiums as well as future coverage under certain insurance carriers, WebMD recommends asking your carrier if yours will be impacted.

While you need to be mindful of the costs involved, you shouldn’t base your choice of doctor on price. The American Society of Plastic Surgeons recommends that your physician

• should have completed at least five years of surgical training with a minimum of two years in plastic surgery,
• be trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction,
• operate only in accredited medical facilities
• adhere to a strict code of ethics
• fulfill continuing medical education requirements, including standards and innovations in patient safety
• is board certified by The American Board of Plastic Surgery or in Canada by the Royal College of Physicians and Surgeons of Canada®

[1] http://my.clevelandclinic.org/services/cosmetic_surgery/hic_neck_lift.aspx

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