I see a lot of patients regarding the appearance of their necks. Many of the patients will say “can’t you just take a little skin out under my chin?” Unfortunately, treatment of the neck, no matter how minor the concern might be, may require more than you think.
The neck is composed of skin, underlying fat than several layers of muscles. Due to age, genes and sun damage the skin loses it’s elasticity and begins to hang . In addition the muscles, specifically the platysma or shaving muscle, begins to fall and widen in the middle changing the very acute angle, as seen from the side, to a very obtuse angle. Fat may increase with weight gain but overall the fat layer will decrease with age. Finally, the jowls develop as facial fat descends due to time and gravity.
There are multiple factors that must be considered when evaluating the neck. First is the fat. Younger patients that have accumulated fat in their neck and have good skin tone may be able to be treated with liposuction alone. The main downside to this is the need to wear a compression garment for several weeks to help the skin retract. However, I see many younger patients that have a small amount of fat directly under the chin, affectionately known as the “waddle.” This needs to be removed directly via a small incision under the chin. The muscles are usually tightened at that time.
Depending on the patient occasionally the platysma muscle will sag while the patient has moderate to good skin tone. This can usually be treated by making a small incision under the chin, removing any of the midline fat and suturing the edges of the widened muscle together.
Finally, when skin and muscles sag the patient needs a full necklift. This involves an incision around the inferior and back of the ear and into the hairline and the incision under the chin. The skin is elevated off of the muscle, the muscles are tightened in the midline, excess fat is removed including the jowls, the skin is redraped and the excess skin is remove.
For any patient in Fairfax, Reston, Manassas, Gainesville, Loudoun, Arlington or anywhere in northern Virginia please call our office for a consultation to discuss your neck concerns.