The process of neck sagging is an unhappy observation for many patients. This is due to pathology involving the platysmal muscles, which acts like a curtain over the neck. There is excess fat herniation and unwanted fat deposits. These abnormalities are usually as a result of ageing but familial issues and a smaller bony chin can also contribute.
The neck lift procedure we carry out is different to the published techniques and four stages.
Firstly a 2.5cm incision is made just below the chin and similar two incisions behind the ears. The incisions behind the ears can be combined with mid-face lift incisions. The platysmal muscle is separated in it’s entirety from the skin. The resultant free muscles are sutured in a corset type technique in the mid-line. The sutures sometimes need to be hitched to the body of the hyoid bone (wish bone).
The second step is to tighten the platysmal muscle laterally to the anterior border of the neck muscles (sternocleidomastoid).
The third step is the placement of two suspension sutures from the mid line (V Ilankovan et al BJOMS, 2005) and the fourth step where these sutures are tunnelled to the post auricular area and anchored to the deep structure of the mastoid bone. The fat is rarely removed but some of the excess skin is removed under the chin and behind the ears.
We have carried out this technique for a number of years and have found a stable neck contour.
The procedure can be combined with mid-face lift and genioplasty. More than 90% of these are carried out under local anaesthetic with oral sedation.
The aim is to give an un-operated look and a sculptured neck.