Neck aging and neck deformity may present itself in a variety of ways:
A well-defined, youthful looking neck is attractive because a number of important components are working together. A satisfactory chin prominence continues straight back towards the throat and then forms a right angle as the neck line continues to the base of the neck. The skin is taut and is of good quality. Minimal to no fat is present under the area behind the chin. A poor angle that continues straight down to the base of the neck is unattractive and may be due to fat accumulation, loose skin, poor projection of the chin or a combination of these deformities. Patients often wear turtleneck sweaters to conceal this deformity and usually avoid photographs of their profile.
Patients who have a fatty neck are candidates for neck liposuction. When heavier cheeks flow into the neck region, additional liposculpture is done under the jaw line to delineate the neck from the cheek. When jowls overhang the neck, this can be corrected with liposuction.
Patients who have fat accumulation under the chin and excess neck skin (“turkey gobbler” deformity) are candidates for a combination of neck liposuction and tightening of the neck muscles (corset platysmaplasty) with skin elevation and redraping of the neck skin. If there is too much neck skin, this excess can be removed by using inconspicuous scars behind the ear.
Neck sag is often noticed in patients who have poor projection of the chin. In these patients, a chin implant is recommended in combination with other neck rejuvenation procedures.
Platysma cords are muscular bands that run from the base of the neck to under the chin, and are quite common in combination with neck aging. Treatment consists of Botox injections for small isolated bands or a muscle tightening procedure to eliminate the neck bands.
Patients who have a combination of facial and neck laxity are more suitable for a combined face and neck lift. Although some patients desire only neck surgery, there are considerable advantages to tightening the face and the neck simultaneously because of the amount of excess skin that can be removed. This results in a more uniform facial rejuvenation with removal of excess loose facial and neck skin. Click here for more information on facelifts.