Youthful Neck: Plastic Surgeons Seek Harmony in Facial and Neck Rejuvenation

Innovative Solutions for Neck Contouring at the ASAPS Annual Meeting

NEW YORK, NY (April 16, 2004) – Wrinkled neck skin, “turkey wattle” under the chin,
and vertical “cords” commonly accompany other aging changes of the face and can be corrected with
cosmetic plastic surgery. Plastic surgeons say that treating the face and neck simultaneously is key to
achieving harmonious, natural-looking facial rejuvenation. The latest methods for neck contouring
will be discussed by leading experts at the Annual Meeting of the American Society for Aesthetic
Plastic Surgery (ASAPS). The ASAPS meeting, April 16-21 at the Vancouver Convention Centre in
Vancouver, BC, is the major international forum for education and research in cosmetic surgery.

The neck is comprised of three layers: skin, fat, and muscle. The platysma muscle, at the
deepest layer, is held together with fascia that works something like shrink-wrap. With time,
however, the fascia stretches, resulting in separation of the muscle and visible cords running
vertically down the neck, giving it a bandy look. The platysma often must be “repaired” or
tightened in the center. In addition, something must be done with excess skin.

In the early days of face lifting, procedures to improve the neck were often done as
separate operations. Today, the face and neck are usually treated at the same time, often in
conjunction with lipoplasty (liposuction) to sculpt the area beneath the chin and jaw line. The
exception is younger patients who have fatty necks but no significant facial aging; they may be
treated with neck contouring alone.

According to panelist and ASAPS President Robert Bernard, MD, of White Plains, NY,
plastic surgeons today have fine-tuned their analysis of the aging neck and developed procedures
that address multiple problems including excess fat, redundant skin, separated muscles, lack of
jaw line definition, and inadequate chin projection.

“Prior to facial rejuvenation, I carefully analyze the patient’s facial anatomy so I can
design an operation that will enhance that important transition from the face to the neck,” says
Dr. Bernard. “Not only will I lift the skin and underlying structures of the face and neck, but I
also will create youthful contours by defatting specific areas for a more sculptured look.
Sometimes,” he continues, “it may be necessary to open a small incision under the chin to
remove fat and access the neck muscles for repair. Some individuals also have a very prominent
gland that bulges directly underneath the jaw line.” Dr. Bernard says that, because there are
delicate nerves in this area, there is controversy among plastic surgeons regarding whether or not
to remove the gland as part of a neck contouring procedure.

Phoenix plastic surgeon Jack Friedland, MD, who will moderate the ASAPS neck panel,
notes that all plastic surgeons agree that treating the neck is an integral part of facial
rejuvenation, and surgery is the only way to achieve significant improvements. “Surgery is
necessary to get rid of sagging skin and repair the neck muscles,” says Dr. Friedland, “but skin
resurfacing procedures may also be used as part of overall neck rejuvenation.”

According to 2003 ASAPS Cosmetic Surgery Statistics, Americans had 125,581 facelift
procedures last year, up 27% since 1997. Over 55% of the people who had facelifts last year
were between the ages of 51-64, and almost 11% were men.


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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