A loose saggy neck is one of the most visible, and for some people, an early sign, of aging. Depending on the patientâ€™s age and neck contour, there are several different approaches to correct this.
There are many patients who come in at a young age complaining about a fatty neck, with poor definition to the jaw line. Those patients who are under 45 years of age should still have sufficient skin elasticity to do well with neck liposuction. There is a small incision made under the chin and liposuction is performed with just local anesthesia. There is some swelling and bruising post-operatively, but the healing is fairly rapid. Most patients will note a significant decrease in the size of the neck, and should get a sharper jawline. However, if a patient has never had a sharp angle to the jaw, this is most likely due to the position of the deeper muscles of the neck, which liposuction will not change.
Above age 45, there is often a loss of elasticity such that liposuction alone will not correct the laxity. Some sort of incision will need to be done at the ear. This can be a cervical lift, where the incision is limited to behind the ear. A better option is to combine this with some sort of a facelift, in that you will get a more natural direction of pull, and better correction of any jowling. These are done at the same time as the neck liposuction.
Another issue for many patients is the presence of â€œbandingâ€ in the neck. There is a neck muscle called the platysma which is directly under the fat. With age, the muscle can separate in the middle and become more visible-producing bands that run from the chin down into the neck. To eliminate these bands, an incision must be made under the chin, and the muscle is stitched together in so it is not so prominent. Any excess fat can be removed at the same time, creating a sharper, more youthful jawline.
In any patient with a “weak” chin, a chin implant is an excellent way to help sharpen the jawline.Â A hard silicone implant is placed into the chin through a small incision just below the chin. The implant sits directly on top of the bone, helping to defineÂ the angle of the mandible, and tighten the neck skin.
Gentle laser resurfacing can also be performed on the neck to help improve the overall texture and color of the neck, and complete the rejuvenation. This is discussed further in the section on lasers.