Question: I’m debating between getting a neck lift alone and a full face and neck lift. My biggest concern is that I don’t want to look overdone. I’m 61 years old and I’ve aged fairly well but in the past few years I’ve developed jowls. How much improvement would I see in a neck lift alone and would this help to maintain a natural appearance?

Answer: A neck lift alone will certainly improve upon your jowls and laxity under your neck but, depending on what the upper half of your face looks like, I may recommend performing a full facelift or a comprehensive approach to rejuvenation so that we retain facial harmony.  What we would desire is for all areas of the face to match and go together since this will create a more pleasing appearance and actually allow someone to appear more natural than one who may have had a single treatment in one area of the face.  During my consultation, I discuss a variety of different techniques as well as combination treatments and then show prospective patients some before and after of my other clients so that they can decide what is best for them personally.  

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Question: I understand that a necklift can be performed on its own, but is it included in a standard facelift? Or would that be a combined face and neck lift?

Answer: It really depends on how we define what a neck lift is since a mini lift or a weekend style facelift would be considered a neck lift in my opinion, but then there are others that like to reserve the words neck lift for a separate procedure that is performed through an incision under the chin where the muscles below the chin are actually directly treated.  In that case, not every facelift gets this approach but frequently a combined approach of the facelift or neck lift with, what is called, a platysmaplasty where the muscles under the chin that are directly treated are combined together to give the result that is desired.  I will mention that most surgeons only perform a platysma plication where they will pull the muscle together in conjunction with a facelift whereas, in my opinion, in many circumstances this is quite inadequate for the creation of a very aesthetically pleasing and elegant neckline.  I, therefore, typically customize my facelift and neck lift approach to the point where I will actually remove fat under the platysma muscle in a very contouring, appropriate fashion as well as frequently even remove muscle deep to this in order to give the patient the neckline that is most desirable.  I will typically combine this with a form of a deep plane facelift to give them extremely significant rejuvenation to the jowl and cheek area.  The combination gives an extremely natural appearing yet extremely rejuvenating result that can last for 10+ years.

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Question: How quickly will I see the results of Fraxel treatment, and will there be any redness or swelling after the procedure?

Answer: Fraxel can cause some redness and mild swelling to the area being treated and in some cases even cause a small amount of superficial crusting of the skin though that is relatively unlikely.  The healing occurs over the first few days and there is very minimal if any downtime associated with this since you should be able to use cover makeup.  The results typically take a couple of weeks to be visible where you will see some improvement in the pigmentation and very minor textural improvements as well.  For more significant improvement, you may want to consider an ablative fractionated treatment, which will certainly add to downtime but will also give you much more significant results.  

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Question: What sort of conditions does the necklift address?

Answer: A neck lift addresses jowls and laxity under the chin by lifting up the deeper layer of the face called the SMAS.  Excess skin is lifted with this and then removed and incisions in and around the ear are closed with sutures that are removed in a week.  It essentially does what most women do in the mirror when they look at themselves and they are showing signs of aging, and that is they grab the sides of their face and they lift a little bit and this lifts the jowls and laxity under the chin and they like what they see.  A neck lift will accomplish this same goal and can be performed in the office setting without the need for any sort of general anesthesia.

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Question: How many incisions are needed for a neck lift procedure?

Answer: Most of my neck lifts, when performed alone, involve an incision in and around each ear that is almost in the shape of an S. This allows the incision to be hidden along the hairline and curves and creases of the ear itself as well as behind the ear. When performed properly, these scars are exceptionally well hidden and patients are extremely pleased with the improvement in their appearance.

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