“I hate my neck” is a complaint we hear from patients on a regular basis both from men and women. Many of those folks are satisfied with the appearance of the face, but it is the neck they don’t like. Neck contour is influenced as much by heredity as aging. So, concern about the neck may exist much earlier in life than age related changes in the face or eyes are noticed. Significant weight changes can also have a dramatic effect on the contour of the neck.
Just like the abdomen, there are 3 layers which are important to neck contour. See “Tummy Tuck Tech” in the January 2014 TOPS or on our website kirnplasticsurgery.com for the corresponding description in the abdomen. The skin, fat, and muscle layers each must be addressed as needed to optimize contour surgically. Also like the abdomen, there are two completely separate fat compartments in the neck, one above the muscle and a second, below the muscle. However, unlike the abdomen, we are able to surgically modify both of those fat compartments in the neck.
Some patients have only a little extra fat in the compartment on top of the muscle. For them, the easiest way to improve neck contour is liposuction, usually completed in the office. Patients who are good candidates for this procedure have healthy, elastic skin which has the ability to shrink up to the new contour. Mostly, this type of procedure is applicable to patients 40 years and younger, but there can be exceptions.
A neck lift (separate from a facelift) allows us to surgically address changes in more than one layer. Extra skin and fat may be removed and the muscle may be reshaped and tightened. Incisions are discreetly placed around the earlobe, behind the ear, and usually under the chin also. A neck lift can yield a dramatic change in the contour and is useful for folks without significant aging in the cheek or jowl formation.
Most commonly, there are changes in the face as well as the neck. Here, a facelift, including a neck lift is appropriate. The key indicator for need of this procedure is the presence of a jowl in addition to changes in the neck and cheek. The same layers in the neck are addressed. Frequently, face and neck lift are combined with other procedures such as fat grafting and eyelid surgery for total rejuvenation.
Following its FDA approval for facelift about a year ago, we have been using the new medication, Artiss, to help decrease recovery time. Our experience has been extremely favorable. Artiss is a fibrin sealant, or fibrin glue, which is used to seal up the surgical zone and stick the skin back down to the newly contoured muscle layer. Drains are no longer required. Uncomfortable chin straps which were previously utilize for several days after surgery are rarely required for longer than the night of surgery, if at all. The real benefit of Artiss however, is that bruising and swelling are significantly decreased. Therefore recovery time is reduced. Over the last year using Artiss, we have had many patients return to work in as little as one week following facelift/neck lift which is dramatically faster than with traditional methods.
While this article is intended to educate the reader on procedure options, the only way to actually determine the correct procedure is by consultation with your American Board of Plastic Surgery certified surgeon. In my practice, a goal of all consultations is to inform and educate you about the available options. Digital imaging, to provide a visual simulation of the anticipated result, is a standard component of our consultations. It is extremely helpful in understanding what the procedure can, and cannot, accomplish. We welcome the opportunity to discuss your concerns and provide state of the art surgical care when appropriate.