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Occasionally, I see patients not yet of an age for which a complete facelift is necessary, but still seeking rejuvenation surgery. In these cases, it's not the entire facial and neck areas showing signs of aging but, rather, just the neck region that's the problem. For these patients, provided the cheeks and jowls are still youthful in appearance, a neck lift (or, possibly, a submental lipectomy) may be the solution.
My Preferred Technique
Neck lifts are beneficial when the problem is limited to loose neck skin—sagging muscles of the neck—and an accumulation of excessive fat, which creates the appearance of a "double chin.” In this circumstance a neck lift with
SMAS, tightening and removal of excess fat and skin is necessary to achieve the desired neck "rejuvenation.”
A neck lift procedure can be viewed as the lower portion of a facelift, omitting the upper portion that's devoted to lifting the cheeks. The required skin incision, resembling an "S” is depicted in the figure to the right:
In addition to the incisions depicted by the white dotted line above, there is another incision just behind the chin, which provides access for fat removal and SMAS tightening. Loose neck skin is then removed along the S-Lift incision surrounding the earlobe and extending just within the hairline behind the ear.
Additional Technique: The Submental Lipectomy
For the very young patient who is troubled by a "double chin,” a submental lipectomy may be the best option. This technique avoids any skin removal, allowing natural youthful elasticity to contract the skin and avoid looseness, as the neck SMAS is tightened and fat removed. In this case, the only skin incision is a short incision just behind the chin.
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