- Why are these changes happening to my neck?
- Who is a candidate for neck contouring?
- What options are available for neck contouring?
- What is computer imaging and how will it be used during my plastic surgery consultation?
- Who is a good candidate for neck liposuction and what does it entail?
- How will I know if I need a neck lift and what will it entail?
- Are a facelift and neck lift performed together?
- Can chin augmentation be performed at the same time as neck contouring?
- How does chin augmentation at the time of neck contouring enhance its results?
- Additional Resources
An attractive neck is perceived as very desirable by women and men alike. In its ideal form, an aesthetically pleasing female neck is graceful: a long, slender “swan’s” neck with a smooth skin surface and a well-defined jaw line and chin. This appearance connotes youth, beauty, and femininity. Fashion designers understand the significance of a beautiful female neck and help draw attention to its appealing contour with their jewelry and clothing.
In a given individual, genetics predetermine the overall shape of the neck. The way the neck ages, therefore, starts from a genetically determined shape that can be somewhat modified with surgery. The goal of neck rejuvenation is to restore the patient’s good looks while still making her look natural.
The anatomy of the neck includes the following layers, in order of depth:
- Outer layer of skin that we see and feel.
- Our insulation layer of fatty tissue, called subcutaneous tissue.
- A pair of broad muscles, called the platysma muscles, which run vertically from the jaw line to the collar bone. The inner edges of these muscles are close to one another in the middle of the neck. The outer edges run vertically in line with the ears.
As we age, our skin loses collagen and elastin, which causes loosening of the skin. Depending on genetics and other factors, such as weight gain, patients can develop fullness in the subcutaneous tissue layer, called lipodystrophy. The aging process also causes the platysma muscles to lose their structural support over time. People often say they have developed a “turkey neck” to describe some of these changes.
Not all patients’ necks have the same shape, nor do their necks age at the same rate or in the same way. Dr. Parker’s approach is individualized to each patient to optimize the result of neck contouring. After examining you during your consultation, Dr. Parker will discuss the options you have to improve the shape and appearance of your neck.
You may be a candidate for a neck contouring if you experience the following:
- excess fatty tissue, or lipodystrophy, in the neck
- a loss of skin elasticity and muscle tone of the neck
- loss of youthful chin, jaw line definition and neck contour
- Liposuction, alone or in conjunction with any of the procedures below
- Neck lift with and without platysmaplasty
- Chin augmentation
Computer imaging can be a very helpful educational tool to show you visually what a particular procedure should do for you. During your consultation, Dr. Parker will carefully discuss various treatment options with you. He will then direct your to our expert photo imager, Liz. She will take photos of your face and neck, and using these photos she will show you what these surgical changes should look like.
These images serve as a great communication tool that will allow you to visualize Dr. Parker’s treatment plan. Dr. Parker will review your images the night before your surgery and then will have them displayed in the operating room on a large monitor. He will use them as guides during your surgery much like an artist uses sketches while sculpting. Neck contouring options can be nicely demonstrated with computer imaging.
Liz will also show you many before and after photographs of patients who have previously undergone neck contouring procedures.
This 34 year old patient was bothered by the “fullness” of her neck since her early twenties. Because the patient had good skin tone, Dr. Parker performed liposuction alone.
Liposuction allows Dr. Parker to remove fat from the subcutaneous tissue layer of the neck and sculpt a more youthful, contoured neck and jaw line. You are a good candidate for liposuction of the neck if you have excess fat along with adequate skin and muscle tone. If your skin and/or muscle tone is lax, you will likely need some type of neck lift procedure. Dr. Parker can determine this at your consultation.
Liposuction of the neck is one of the most popular liposuction procedures in cosmetic surgery today. If appropriate, it can be performed at the same time as other procedures, such as a facelift, blepharoplasty, or chin augmentation.
In performing liposuction, Dr. Parker makes a tiny, 3 mm incision under the chin and behind each earlobe. The area to be sculpted is infiltrated with our “super wet” solution. A thin liposuction cannula is inserted through these tiny incisions to remove excess fat and sculpture an improved neck contour. In patients with moderate skin tone, Dr. Parker will use the Vaser ultrasonic liposuction system to emulsify fat before removal as well as tighten the overlying skin.
Liposuction of the neck takes about 30 minutes to perform under local anesthesia, usually supplemented with light intravenous sedation. Patients are discharged shortly after the procedure. There is little pain, and sutures inserted to close the tiny access incisions dissolve by themselves. Swelling and discoloration typically subside within 7 to 10 days. Camouflage make-up can be applied after one week. Patients may return to normal activities in 3 to 4 days and exercise in 10 to 14 days. Results are usually quite dramatic in shaping a more youthful, attractive neck.
You will likely need some type of neck lift procedure if you have laxity of your neck skin and/ or platysmal muscles. Dr. Parker will determine this and discuss it with you at your consultation. There are several options here. The components of a neck lift include fat contouring, lifting and tightening the platysmal muscle, skin re-draping and redistribution, and skin removal.
This 46 year old patient was bothered by the laxity of her neck skin. Dr. Parker performed a neck lift through incisions behind both ears. This allowed him to suspend the platysmal muscles laterally. He then removed excess skin through these same incisions.
In performing a neck lift, Dr. Parker makes incisions behind each ear to separate the skin in the neck from the underlying platysmal muscles. He removes excessive fat, and then lifts and tightens the fascia at the outer edges of the platysma muscles on both sides of the neck using sutures. This creates a “hammock” effect whereby the suspended platysma muscles create a long-lasting and natural shape in the neck.
Patients who demonstrate true laxity of the platysma muscles have the inner portion of these muscles tightened with sutures through a limited incision beneath the chin; this is called a “platysmaplasty.” Dr. Parker then removes the excess fat, leaving behind a uniform, thin, and contoured blanket of fat. Finally, he re-drapes the neck skin, removing excess skin through these same incisions behind the ears. These incisions are then closed with dissolvable sutures so the scars heal well.
This 58 year old patient was bothered by the crepiness of her neck skin and prominent muscle banding beneath it. Dr. Parker performed a platysmaplasty, whereby he re-contoured the underlying platysma muscle with sutures through a limited incision beneath the chin and re-draped the lax skin.
The time for surgery ranges from 45 minutes to 2 hours, depending on the extent of skin and muscle laxity, and patients receive either intravenous sedation or general anesthesia. Patients are discharged within one hour after surgery, or stay overnight, depending on the extent of the procedure. Initially, there is a feeling of tightness under the neck from the “hammock” effect. Stitches are removed within one week. Swelling and discoloration subside within 10 to 14 days. Camouflage make-up may be applied after one week. Patients may return to normal activities in 10 to 14 days and exercise beginning at two weeks.
A facelift addresses the lower two thirds of the face and is often combined with a neck lift. During your consultation with Dr. Parker, he will evaluate your face and neck together, then discuss treatment options to address them with either a facelift, neck lift, or both.
This 68 year old was bothered by the aging of her face and neck. Dr. Parker performed a combined face and neck lift along with fat injections.
During your consultation with Dr. Parker, he will listen to your concerns and perform a physical examination of your entire face and neck to assess your skin, underlying soft tissues, and bony support. Dr. Parker will then review his findings with you as well as the various options for treatment. This will allow him to customize a treatment plan for you based on your concerns, individual anatomy, resources, and time for recovery.
The results of neck contouring can be dramatically enhanced with a chin augmentation.
In a patient with a weak chin undergoing liposuction of the neck, a neck lift, or both, Dr. Parker performs a chin augmentation. Using a ¾ inch incision hidden just beneath the chin, Dr. Parker places an extended, tapered silicone chin implant along the jaw. The implant is held in place with sutures and quickly adheres to the jawbone. It looks and feels just like a real chin. It creates a stronger, natural looking chin, which adds to the aesthetics of a cleaner jaw line in a neck contouring patient.
It takes about 20 minutes to perform a chin augmentation. Swelling and discoloration subside within several days. Patients can return to normal activities in three to four days and exercise in 10 to 14 days.
This 39 year old had always been bothered by the fullness of her neck and her weak chin. She said these were family traits. Dr. Parker performed liposuction to contour the patient’s neck and then inserted a chin implant during the same surgery. Note the stronger chin and markedly improved neck contour following both of these procedures.
Dr. Parker performed a facelift and neck lift in this 48 year old patient along with a chin augmentation. Notice the stronger, cleaner jaw line in addition to the rejuvenated appearance of the patient’s face and neck. Computer imaging helped the patient understand what these different options would do for her and helped her make an informed decision.
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Paul M. Parker, M.D. · Parker Center for Plastic Surgery · Paramus NJ