Neck lift surgery or lower rhytidectomy (neck cosmetic surgery)
Neck lift surgery or pulling back the neck skin is usually used when the neck skin sags and descends due to aging. But this surgery is not performed just for this reason because it is also used for neck beautifying. In the sequence, we will be familiarized more with the criteria of neck beauty, as well as the reasons for neck lift and how to perform this surgery.
Neck beauty criteria
Jawline prominence (Jaw-chin angle)
Jawline prominence is among the important criteria of neck beauty that significantly affect face beauty as well. The lower jawline prominence is the characteristic of beautiful necks. This line causes the head and neck border to be well defined.
Some parts of this line are not seen in people whose lower jaw has not grown enough, or this line has faded away due to fat accumulation above the neck, as well as the elderly in whom this line is not seen due to the tissues drooping. However, this beauty criterion can be reconstructed using surgical or non-surgical methods. We address different methods used to beautify the jawline in other parts of this website.
The line that runs from under the chin area to above the hyoid bone should be straight (or slightly convex).
Neck-chin angle
The neck-chin angle should be between 105 and 120 degrees.
Factors, such as aging, accumulation of fat above the neck, and chin tissue atrophy cause this angle to become larger over time.
Chin ratios
The horizontal to vertical part ratio is 1/2 or more.
Young and beautiful chin
The chin is located above the frontal part of the neck and its beauty has a significant effect on the neck beauty. The small size of the chin can cause the above part of the neck to look larger in volume and may create the appearance of a false double chin. In people with small chins together with fat or saggy tissue accumulation in front of the neck, the ugliness (a double chin) is seen more severe than reality.
Click for detailed information about double chin surgery
Youth of neck tissues
In a beautiful neck, the skin is smooth and wrinkle-free. The edge of the platysma muscle (superficial muscle of the neck) is not seen and the enlargement or sagging of the salivary glands and other tissues of the mouth floor are not observed.
Effect of aging
Appropriate strength and consistency of tissues in dynamic mode
A young neck shows its beauty and strength not only in the static state but in the dynamic one. It can be said that the first and most important change that occurs in the neck with aging is the dynamic drooping of the neck tissues that is shown as tissue accumulation beneath the chin and jaw when the head is bent downward.
Neck beautifying surgery method
Several surgical and non-surgical measures can be taken in order to return the beauty criteria back to the neck. Most of the measures taken to beautify the neck in the youth (people under the age of 40) try to eliminate the double chin and augment the lower jaw to well specify the head and neck border.
I recommend that people at these ages use non-surgical methods, such as gel injection, etc., or undergo small and more limited surgeries. Although I first recommend that older people (especially, those above the age of 45) use again non-surgical methods, most of them choose broader surgical procedures (e.g., neck lift) as the non-surgical methods lead to small and less durable changes.
Neck changes with aging
As we get older, the neck is also affected by aging-induced changes like other parts of the body. The neck skin and subcutaneous tissues are constantly being stretched and contracted due to excessive movements of the neck during life and will descend and droop over time. Like what is observed in the face, the tissues atrophy and changes in the fat amount are also seen in the neck as we age. In summary, it can be said that the following changes occur in the neck with age:
- Fat accumulation under the chin
- Platysma laxity (cervical SMAS)
- Chin atrophy and the jawline and jaw angle fading away
- Loosening and sagging of the skin and tissues under the chin and submandibular gland
- All of the above changes lead to the formation of a double chin resulting from aging
At what age do the signs of neck aging appear?
Usually, from the beginning of the fifth decade of life (above the age of 40), the looseness and drooping of the neck skin and tissues become visible. At first, these droopings are dynamic, that is, they are seen when the head is bent down (e.g., when we study or look at the mobile phone screen) and they are reduced or completely eliminated as the head is turned back forward.
Who are the right candidates for neck lift?
Despite the equal prevalence of aging symptoms in men and women, it is mostly women who attend for neck rejuvenation.
How is neck ugliness treated?
A false double chin: Chin augmentation or lower jaw surgery are the best choice in people with false double chin (caused by the small size of the chin or lower jaw). We provide an explanation about chin augmentation surgery in other parts of this website.
Reduction of fat accumulation under the chin: Open or closed removal of fat (liposuction) beneath the chin can be a way to correct double chin caused only by fat accumulation. Diagnosis of this state is of paramount importance because only 5-10% of people who attend for double chin removal and correction fall under this category and the appearance of double chin in others is accompanied by other reasons besides the fat accumulation in the superficial layer. Therefore more actions are needed to be taken for a double chin correction.
Who are the right candidates for double chin suction (submental liposuction)?
A double chin suction can be done in every young person (under the age of 40) in whom the under the chin tissues and above the neck skin are strong enough, and the only cause of double chin is the excess accumulation of fat in the superficial layer under the chin. This group of people is the only group that can obtain a suitable result from double chin suction.
It is very likely that persons develop complications if double chin suction alone is done in the older people (above the age of 40-45), and it is not recommended without neck lift. The complications can appear as roughness or sagging skin (the following picture shows the result of double chin suction in an old person).
Neck lift surgery
In all the elderly (above the age of 45) with visible laxity and drooping in the neck tissues, neck lift yields the most durable result. Neck lift surgery is the only procedure that can simultaneously remove all factors causing ugliness in the neck. By strengthening floor-of-mouth muscles in this method, the dynamic drooping above the neck is corrected, and at the same time, the neck and face border can be well defined at the same time with chin prosthesis installation. Neck lift surgery makes it possible to create proportionality between the horizontal and vertical parts of the neck. This surgery is approximately the only method that can correct the platysma banding of the neck.
platysma banding of the neck, enlargement and sagging of the submandibular gland:
In some people, enlargement or sagging of the submandibular gland appears as a protrusion under the mandibular trunk (the jaw-chin angle). If the enlargement of the salivary gland causes severe ugliness effects on the neck, a part of this gland can be removed at the same time with neck lift surgery, and the function of this salivary gland can be preserved by keeping the main parts of this gland besides beautifying the neck.
