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Am I too old for a neck lift alone?

Q:

I am 48 years old and in excellent health and physical condition.  What bothers me most about my appearance are the vertical bands in my neck which I understand are the platsyma muscles separating with age.  I am nervous about getting a face lift and wondered if a neck lift alone might give me good results.

A:

An examination would be required to determine what would be ideal for you, but it is quite possible that a necklift alone could provide a wonderful result. Immediately under the skin of the neck is the platysma muscle, which you can easily see in a mirror when you clench your teeth and tighten your jaw. In youth, this paired muscle meets in the midline below the chin. With age, the right and left sides of the platysma often separate, producing vertical cords in the anterior neck. The platysma can be divided anteriorly and tightened during neck lift cosmetic surgery to permanently eliminate these cords and improve the neck contour. Once tightened in the midline below the chin, lateral traction on the platysma then creates a sling which elevates the soft tissues below the jawline.

Michael Law, MD

A:

Facelifts come in many forms. Most require significant undermining and central manipulation of the muscle to correct the neck. They also pull backward as much as they pull upward. This can give an unnatural appearance to the face. This is the reason a separate neck lift was developed, to reduce the procedure, especially in people your age. However, they, too, pull in the wrong direction. Additionally, while a lot of what you see is in the neck, most of it came from the face, and a neck lift will not address the facial aging. Newer procedures can be tailored to your individual needs and provide natural rejuvenation of both the face and neck, occasionally with little incision behind the ear and minimal undermining of the neck. I personally use a modification of the MACS Lift and will not do a stand alone neck lift. I find that the procedure itself and the recovery are essentially the same as with the neck lift and the results are far superior.

R.T. Buchanan, MD

A:

A definitive answer would require a photo or a consultation. Generally speaking by the time we see significant bands in the neck we also see age associated changes in the lower face. A neck lift can address the bands but will not address the lower face. Your best course of action is to seek out a board certified plastic surgeon for an evaluation. Learn about your surgeon's technique and review before and after photos to understand the results that can be achieved.

I hope this was helpful and I wish you the best.

R.W. Kessler, MD

A:

The simple answer is yes an isolated neck lift can be performed in some cases. The issue is trying to avoid a facial appearance where balance had been lost.

R. Whitfield, MD

A:

Am I too old for a neck lift alone?

A neck lift alone can often make someone look younger, better and thinner. However, not everyone will get a pleasing result with a neck lift alone, no matter what technique is performed, and there are a number of variations of how to perform a neck lift. Many patients will get a better and more harmonious result with a well performed natural appearing face and neck lift.

Whether you are a candidate for just a neck lift depends on your desired outcome, expectations and individual anatomy: platysma separation, skin tone, extent of skin laxity, and how much jowl drooping exists. The best approach is to have an examination and consultation with a plastic surgeon who is board certified by the American Board of Plastic Surgery, and ideally a member of the American Society for Aesthetic Plastic Surgery. That will give you an opportunity to discuss the positive and negatives of the various alternatives, so you can make a fully informed decision.

Robert Singer, MD FACS

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