Answer: I commonly hear this same question. Many women in your situation are concerned about looking overdone. Even for those who have aged well and have more changes in the neck than the mid-face, there most likely has been some volume loss and sagging in the cheek region. You should see dramatic improvement in your neck and jawline with a neck lift alone. You would most likely be completely satisfied with this procedure. I usually suggest to my patients, however that they have the full face and neck lift. This is primarily because there is virtually no difference in recovery time and only slightly more scarring with the full procedure. With this there will be equal improvement in the mid-face or cheek region which will dramatically improve the overall result. The mid-face portion of the lift can produce the desired improvement while still maintaining a natural appearance.

Answer: This is a great question. As your plastic surgeon, when seeing you in consultation for chin or sub-mental liposuction, these are exactly the options that I am considering. Improving the aesthetics of this part of the face primarily involves correcting and contouring the angle between the chin and the neck (the cervico-mental angle) as seen on profile. Other factors include achieving the ideal volume, shape and contour of the chin.

When the size of the chin is deficient, particularly in outward projection, it is augmented either with an implant, or with fillers or even with orthognathic surgery which actually advances part of the bone forward.

When excess fat has accumulated beneath the chin and in the central neck, then contour is improved either with liposuction or with direct excision.

When the cervico-mental angle is obscured due to laxity of the skin and underlying soft tissues of the neck, then tightening of these tissues with a necklift is indicated.

In general, for my patients in their 20s and 30s I most often perform liposuction, with or without a chin implant. For patients in their 30s and 40s, using a small incision beneath the chin, I often perform liposuction and or direct fat excision combined with tightening of the muscle (platysma) in the central neck. This may also be combined with a chin implant. For my patients on their 50s and over, I am more likely to recommend a full necklift, with or without chin augmentation.

Answer: A neck lift procedure can be performed under local anesthesia. Often, especially for more extensive neck lifts, both the patient and the surgeon may be more comfortable having the procedure performed with IV sedation given in addition to the local. The incision is usually made around the ear, front and back, and extending along, or just within the hairline behind the ear. The neck skin and fat is separated from the deeper layers, then pulled back and up, and the excess skin is cut off. The skin tightening improves the contour of the neck, particularly at the angle between the neck and chin, and along the jawline.