Deep Neck Lifting
Neck rejuvenation surgery
Approaching the neck during face and neck lifting surgery can be done in a number of ways. The mainstay approach is a deep plane facelift, using incisions which are placed around the sideburns in front of the ear, as well as behind the ear. This allows access to the platysma muscle (the “turkey neck muscle”) which can then be pulled backwards and upwards in order to tighten the neck.
Other components of the neck and under chin area
However, in many people, their necks are not sufficiently improved with this manoeuvre alone. The reason for this is the that the shape of the neck can be affected by not only by sagging soft tissues (that can be pulled up) but also by deeper layers of firmer tissues that need direct surgery. These tissues lie between the skin and the floor of the mouth, under the chin. They are composed deeper muscles, fat compartments and also the submandibular salivary glands, which over time and with age, can start to hang down and contribute to the fullness in the neck. This adds additional volume to the neck and needs to be addressed separately from a lower face/neck lift to adequately re-shape and rejuvenate this area.
How do I know if I have “deep neck” volume?
A good way of determining whether or not you have the deep neck structures that are contributing to the fullness and shape of your neck, is to compare a photograph taken from the side with you lying down against one of you standing up (also from the same side view). If your neck does not change significantly in shape when comparing the lying down version with the standing up version, and there is still some fullness to the neck, then it is likely that the reason for the fullness is due to deep volume presence in the neck and the under chin area. As mentioned above, this can only be reshaped and improved with deep neck surgery, accessed from a separate incision under the chin.
How id deep neck surgery performed?
The surgery in the neck can be complex and would either be an additional procedure to a deep plane facelift, or alternatively in some people (particularly those with younger and good quality skin) a tremendous improvement can be achieved through the under-chin scar alone without the additional need for a deep plane facelift.
The structures that can be changed with a deep neck lift include the following:
The deep neck fat can be excised (fully or partially) to reduce the volume under the platysma muscle.
The digastric muscles can be tightened and/or can be reduced in size to further help reduce the volume of the neck.
The submandibular glands can be reduced in size if they are bulky or if they are hanging down below the level of the jawline, and therefore affecting the contour of the jawline and neck.
If you have a substantial amount of fat between the skin and platysma muscle, this can be directly removed, or removed using liposuction techniques.
The platysma muscle itself can be tightened by stitching either side together in the middle, and, if necessary, releasing any tightness with further incisions.
What are the effects of deep neck surgery?
As you can ascertain from above, deep neck surgery is somewhat complex, but it can transform the contour of someone’s jawline and neck, and enhance the result they would otherwise be able to achieve from a more traditional lower face/neck lifting approach.
There is no “right” operation but your individual decision on how to proceed will be a joint one with me, taking into account your expectations, your goals, your comfort with the surgical plan and acceptance of risk, as well as other factors. What is key, is to understand what expectations are realistic and what might be achievable with different approaches to rejuvenating the lower face and neck to enable you to make the best decision for yourself.