Neck Lift

The term neck lift can be confusing for patients because the name implies that an incision under the chin can correct aging in the neck, but almost all patients with significant aging in the neck actually require a facelift–which is why the facelift could more accurately be called the face and neck lift. As noted above, pulling loose tissues from under the chin and the front of the neck back into a more youthful position requires lifting the SMAS layer and platysma muscles (the muscles that contribute to the vertical bands in the neck) into a higher position; since these tissues originate in the face, they must be lifted back into the face. Furthermore, excess skin of the neck cannot simply be cut out using incisions on the neck, since these would leave obvious scars. The excess skin has to be trimmed using hidden incisions around the ears and hairline. Thus, a neck lift is really a face and neck lift.

The term open neck lift refers to a procedure used in conjunction with a facelift, in which an incision is placed under the chin, allowing removal of deep fat in the neck and tightening of the front of the platysma muscles. The open neck lift is used in conjunction with the facelift primarily in patients who either have heavy necks (and therefore require deep fat removal) or have prominent vertical muscle bands in the neck (and therefore require suturing and release of the platysma muscles in the midline).

There are some young patients who have heavy necks, who may in fact be able to have an isolated incision under the chin to remove fat and tighten the platysma muscles. These patients do not require a facelift. The goal here is not rejuvenation, but increasing the depth and definition of the neck and jawline. Many of these younger patients are candidates for liposuction to the jawline and submental area (under the chin) alone, without open removal of fat. For such patients, consultation with a qualified facial plastic surgeon can help clarify whether liposuction alone or with an open neck lift is best.

Good candidates for an isolated open neck lift are generally younger, with tight, elastic skin, but heavy necks that would benefit from deepening, contouring, and defining, which often gives the appearance of weight loss.

Patients with signs of aging, including jowling and the so-called "waddle" under the chin are good candidates for the deep plane facelift to rejuvenate the lower face, midface, jawline, and neck. The open neck lift is added for rejuvenation patients who have a heavy neck and require deep fat removal and for patients who have thick vertical muscle bands requiring suturing and release.