Neck Lift

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A neck lift is a family of treatments that address problems with fat, muscle and skin on your neck and jawline. It helps to correct excess flesh on the neck and jowls and gives a contoured and youthful appearance. If there is enough elasticity in the skin, you may benefit from having liposuction (removal of excess fat) alone. Patients may also require liposuction in combination with a platysmaplasty (tightening of the muscles of the neck), to produce a sculpted, angular and youthful jawline. Patients with loose facial and neck skin often choose both a neck lift and facelift. This is in addition to or instead of liposuction.

In order to best understand neck lift surgery and what it can accomplish, it is important to be familiar with the major anatomical structures in the neck. Summarized below are the anatomical neck structures that are involved in the neck lift procedure.

The cervicomental angle is the angle between the lower aspect of the chin and the start of the neck. Research has shown that the cervicomental angle is an important part of determining attractiveness, with angles ranging 90-105 degrees considered to be most attractive and angles above this range considered to be less attractive. The hyoid bone is a bone in the upper part of the neck which helps determine the cervicomental angle.

The hyoid bone is a U-shaped bone located in the anterior part of the upper neck. While its main role is to anchor the tongue, several muscles in the neck also attach to the hyoid. The hyoid bone helps with chewing, swallowing, and speech. The exact location of the hyoid bone varies from person to person, and its position helps determine the cervicomental angle.

Subcutaneous fat is the most superficial layer of fat, located just below the skin. This layer of fat is generally thin in young slim people, such that the prominence of the thyroid cartilage may be visible. As people age or gain weight, the amount of subcutaneous fat may increase.

The platysma is a broad muscle in the neck that spans from the mandible to the clavicle area. As we age, the platysma becomes weaker and thinner. The weakening of the platysma muscle causes sagging in the neck and the development of platysmal bands, which are one of the first signs of aging. It is important to note that the platysma is the continuation of the SMAS (superficial musculoaponeurotic system) which has important implications in facelift surgery.

Subplatysmal fat is the fat located deep to the platysma. This fat is located deeper in the neck than the subcutaneous fat. Subplatysmal fat is more likely than subcutaneous fat to increase over time and since it is deeper, it is more difficult to access from a procedural standpoint.

Digastric muscles are a pair of muscles in the neck that help with chewing, swallowing, and speech. The digastric muscles serve as an important landmark during neck lift surgery. Enlarged digastric muscles can give a bulging appearance to the neck, which people may find aesthetically unpleasing. Reduction in the size of the digastric muscles can be accomplished with a neck lift procedure.

Submandibular glands are glands located in the upper neck that produce saliva. The submandibular glands serve as a landmark during facelift surgery, as they are in close proximity to important nerves and arteries.  Prominent submandibular glands can make the neck appear excessively full and give an irregular contour to the neck. It is possible to remove part of the submandibular glands during neck lift surgery.

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