A face can hold on to its youth while the neck below it does not. Skin under the jaw loosens, the angle beneath the chin blurs, and a profile photo tells a different story than a straight-on glance in the mirror.
One Houston-area practice builds part of its neck lift guidance around this pattern. The neck lift guidance published by Dr. Leo Lapuerta, a Houston-area triple board-certified plastic surgeon with more than 30 years of experience, describes patients who are happy with the youthful look of their face but troubled by a neck that gives away signs of aging earlier. For those patients, the practice says, a full facelift is not yet necessary, and a neck lift can help the neck match the face above it.
The forces at work
The practice names the causes without hedging: weight loss, genetics and the passage of time. Each one can leave sagging skin that makes a person look older than their age.
The neck carries its own anatomy. A thin sheet of muscle called the platysma runs down the front of it, and the skin over it can stretch and lose its fit. Fat can collect beneath the chin. Any of these, alone or together, can produce jowls along the jawline or the look of a double chin, the two complaints the practice names.
Bone plays a part too. The practice points out that some patients who believe they have a neck problem have a weak chin. Without enough support from the chin bone, the neck cannot hold a defined contour.
The parts a neck lift changes
Dr. Lapuerta divides the surgery into two procedures. Platysmaplasty alters the neck muscles. Cervicoplasty removes excess skin. Liposuction comes first if fat pockets stand in the way of the result.
The incision sits under the chin and, in some cases, behind or in front of the ears. After any fat removal, the platysma is pulled tight and the overlying skin is redraped to create definition. Sutures go deep within the neck wall, and a drain may be placed to control bleeding. The practice performs the procedure as an outpatient surgery under general anesthesia at its accredited on-site facility, where it takes about two hours, depending on the case.
For a weak chin, the practice may recommend a chin implant to reshape the chin and make it wider or more prominent. It notes that a neck lift may still be needed once the chin has been corrected.
Why loose skin points to surgery
On non-surgical options, the practice is direct: excess skin in the neck has to be removed surgically. Non-surgical treatments may help other concerns, but once the skin itself has stretched, the practice regards surgery as the way to redefine the neck and restore its contour.
Scars follow the incisions under the chin and near the ears. The practice places them within the hairline at the ears and beneath the chin, so they stay out of view when the patient looks straight ahead. Like any operation, a neck lift carries risks, which belong in the pre-surgery discussion.
A wider age range than people expect
The neck lift is not limited to older patients. The practice says people in their 20s and 30s may benefit, in particular those who have had a massive weight loss or have a hereditary defect of the neck. Patients in their 60s and 70s often choose the procedure to treat visible signs of aging. For weight loss patients, Dr. Lapuerta recommends reaching or nearing goal weight first.
He explains his attraction to this kind of work in his own words: “I love plastic surgery because it is an opportunity to take what appears to some as a negative or a deficit and reconfigure and reimagine that undesirable quality into something desirable that brings vitality and joy to a patient.”
Dr. Lapuerta serves as Chairman of Plastic Surgery at St. Joseph Hospital and has performed more than 30,000 surgical and non-surgical procedures. The practice says most neck lift patients return to work within seven to 10 days, though the neck can take several months to look and feel natural.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.
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