Neck Lift Surgery in Sydney
Neck Lift Surgery aims to restore
A neck lift procedure aims to alter the appearance and position of neck skin, fat and muscle. Skin, fat and muscle in the neck can all contribute to a changing neck contour with age. Changes in the neck are often noticed earlier than those in the face, eyelids and brow. A period of weight gain or loss may precede their development.
Risks of surgery
Cosmetic surgery is a serious decision. Information about the risks of a neck lift can be found here.
As we age, the area under our chins can develop excess fat, skin, muscle or a combination of these. This can give the appearance of weight gain even if you have not actually gained any weight.
Results vary from person to person.
Cosmetic surgery is a serious decision. More information about the risks and recovery of each procedure is available on our website.
All surgery performed by Dr Jason Roth (MED0001185485), Otolaryngology head and neck surgeon, Sydney.
Requests to alter the aging neck occur in both men and women.
Often the redundancy of the neck tissues is also seen in the face. In many patients the excess tissue in the neck was originally located up in the face and has fallen slowly over many years below the jawline into the neck. Sun exposure, genetic factors as well as significant changes in weight can accelerate this process.
In a neck lift procedure redundant skin, muscle and fat is contoured and re-positioned. Sutures are used to reconstruct and suspend the tissue.
Sometimes a small incision is necessary under the chin where the hanging edges of the platysma muscle are stitched together. Further small incisions hidden around the ear and hairline allow the neck tissues to be lifted and tightened. Some skin is always removed.
A neck lift can be combined with a facelift to address concerns in the midface and upper face. The incisions (scars) for a neck lift are in a very similar location to a facelift so these two procedures are very often performed together. A deep plane facelift procedure is an effective way to elevate and recontour neck tissues.
Long lasting necklift results are obtained when there is full release of the retaining ligaments of the neck and face. Once these are released, the neck and facial tissues can be gently repositioned with no tension. Three important retaining ligament groups are the cervical, mandibular and zygomatic.
The neck can be a challenging area to treat with more traditional surgical techniques such as the “skin only” neck lift. Injectables (bo-tox, fillers) are unfortunately often not very helpful in the neck.
Dr Roth is based in Sydney and specialises in the deep plane facelift, vertical neck lift technique (also known as the vertical platysmal advancement technique) as popularised by Dr Andrew Jacono and Dr Neil Gordon in the USA. The vertical neck lift is an extended deep plane facelift that elevates the skin and SMAS-platysma complex as one unit. It can provide long-lasting results. Laxity in the neck is dealt with by repositioning tissues to a more elevated position in the face and jawline.
The vertical neck lift technique does not routinely require midline platysmal surgery (a platysmaplasty) as it is can provide sufficient movement by vertical movement of tissues to camouflage prominent platysma muscle. It is powerful when needed and can be used in many different anatomical situations.
Adjunctive procedures
A number of adjunctive procedures may be performed at the time of a necklift, depending on patient anatomy. These include removal of excess skin, liposuction, a platysmaplasty, reduction in the size of the digastric muscles or submandibular gland suspension or removal.
Skin removal
Neck skin . The platysma muscle (which is often very prominent in younger patients) tends to thin out leaving redundant overlying skin.
Generally some skin is removed with any necklift procedure apart from in the youngest patients. The actual amount removed varies between patients depending on their anatomy. Skin incisions are designed to optimise loose skin removal, smooth re-draping and hide scars.
Neck Liposuction
Liposuction removes fat cells through a small suction device. 3 tiny “ports” or cuts in the skin are required to insert the device used to remove the fat. Liposuction only removes fat and does not address excess skin or platysma muscle that may be redundant in the neck. It can be a useful adjunct when recontouring the neck with a necklift procedure. Occasionally it is performed in isolation without other procedures. Neck liposuction needs to be done conservatively to avoid an “overdone” look as well as scarring.
Platysmaplasty
This procedure focuses on the platysma muscle that sits just underneath the skin’s surface at the front of the neck. Over time, this muscle can create vertical bands in the neck.
Caption: There are a number of variations in platysma anatomy
Sometimes the two edges of the platysma near the midline hang with a hollow area in between.
Image depicts the underlying muscle bands being sutured back together.
A platysmaplasty is a surgical procedure that stitches the edges of the muscle together and can create a smoother neck surface. A small incision is made under the neck which allows the two edges to be sutured together in the midline. Once the muscle has been stitched together, it can be lifted by other small incisions located near the ear.
In the majority of patients who undergo a vertical neck lift which includes a deep plane facelift and necklift, a platysmaplasty is not necessary as the lift procedure will eliminate sufficient redundant platysma muscle. Whether or not a platysmaplasty is needed can be determined at the time of a pre-operation consultation. The essential test is whether the neck redundancy is completely eliminated when the face is lifted from the sides without excessive tension. If that is the case, a platysmaplasty is often not needed.
Digastric muscle reduction
Fullness under the chin can often been partially caused by a low hanging belly of the digastric muscle. This is particularly the case in individuals who are born with a hyoid bone that sits low in the neck. The digastric muscle attaches to the hyoid bone. The anterior belly of the digastric muscle can be partially reduced in size to improve the contour of the upper neck.
Image depicts the digastric muscle being reduce in size.
Image depicts the digastric muscle being partially reduced in size.
Submandibular gland suspension or removal
The submandibular glands tend to descend down into the neck with age. This can lead to a bulge in the upper neck about halfway along the jawline. It is important to support and elevate the submandibular glands as part of a necklift procedure.
Dr Roth often uses a technique whereby the platysma muscle is tightened like a hammock under the submandibular gland to effectively tuck it upwards under the jawline. In some cases a partial removal of the gland is necessary.
Chin implants
A recessed chin can impair a good neck lift result. A chin implant can be inserted at the same time as necklift surgery for a better result if needed.
Submental fat removal
If prominent, fat under the chin may need to be removed directly. This can be done with scissors or liposuction. The fat can be located over the top of the platysma muscle, between the muscles in the midline or underneath the muscle.
Dr Jason Roth is a Sydney-based Specialist Otolaryngology and Head & Neck Surgeon who is trained to perform neck lift and facelift procedures safely and effectively. He has trained with Dr Neil Gordon, one of the leading facelift and neck lift specialists in the United States. He has also been certified with the International Board Certification in Facial Plastic Surgery.
About Dr Jason Roth, MBBS, FRACS
Dr Jason Roth is a Sydney Otolaryngology Specialist and Head & Neck Surgeon with Facial Plastic Surgery Fellowship training from Australia, the United States and Europe. He is an expert in Facelift Surgery, Rhinoplasty, Nose and Sinus Surgery.
He consults from his clinic in Dee Why and operates at several private hospitals across Sydney. Importantly, Dr Roth performs more than 50+ face and neck lift operations per year, which makes him one of Sydney’s busiest neck and face lift surgeons. Dr Roth has exposure to a high volume of patients with both common and rare clinical problems, allowing him to develop a depth of expertise. View his full profile here.
