It seems to happen rather suddenly: for years, your neck is firm, with a crisp jawline outlining your face—and then at some point , you notice that the skin from your chin to your chest just looks loose. What’s to blame? It might be age, genetics, gravity…the list goes on. But at the top of the day, no number of pricy creams, facial exercises or at-home jawline sculpting tools will significantly stiffen jowls.
Luckily, there are two prominent in-office procedures which will deliver visible neck-correcting results: a lower facelift and neck lift. While both can create more definition along the jowls, there are a couple of major differences between them. Here, we break down each procedure and its potential risks in order that you’ll decide which one is true for you.
First, what’s a lower facelift?
“A lower facelift corrects the jowls and therefore the neck [by repositioning the skin and muscle],” says ny City facial cosmetic surgeon Dr. Jennifer Levine. During the procedure, the upper portion of the platysma muscle—which extends from the upper chest, over the collarbone and along the edges of the neck—is often adjusted. The platysma muscle is connected to a layer of firm tissue, or fascia, called the superficial musculoaponeurotic system (SMAS). “By repositioning this layer, tissues and fat pads that have descended are replace to their original positions,” explains Southlake, Texas, facial cosmetic surgeon Dr. Jordan Rihani. “This also allows improvement within the appearance of the nasolabial folds and marionette lines.”
While a full facelift can treat sagging along the upper face, midface and lower face, a lower facelift specifically targets loose jowls, laugh lines and sagging cheeks. The incision for a lower facelift typically begins near the front of the ears and extends to the hairline. Skin, fat tissue, and therefore the platysma muscle are then pulled into a lifted position so as to offer the jawline a way tighter appearance.
What is a neck lift?
A neck lift is analogous in concept to a lower facelift, but the most goal is to enhance the looks of the neck—not laugh lines or sagging cheeks. “The incisions are continued further behind the ear and into the hairline, to get rid of excess skin of the neck,” says Dr. Rihani. “The SMAS layer is repositioned during a similar fashion [as a lower facelift] but extends further down [the neck].”
Additionally, if a patient has prominent bands within the front of the neck, these are addressed through alittle incision under the chin during a neck lift. As we age, the platysma muscles tend to separate and make two distinct vertical bands that run from the chin to the chest. due to this, doctors often choose a platysmaplasty—aka neck lift—in order to stitch these two ropey-looking bands together and smooth the world .
For those trying to deal with a buccula , liposuction is usually combined with a neck lift so as to get rid of excess fat from the world and improve the angles of the jaw. Finally, patients who struggle with skin laxity—which is that the main explanation for the dreaded turkey neck—will undergo skin trimming during a neck lift, to sharpen the jawline.
“Patients who have tons of skin laxity within the neck and wide separation of the platysmal bands within the midline, will inevitably require a lower facelift at an equivalent time,” says ny board-certified facial cosmetic surgeon , Dr. Dilip Madnani. “It’s very difficult to deal with just the neck banding without addressing the jowling, the face and neck skin and muscle layers are continuous.”
While some people use these terms interchangeably, there are clear differences between the 2 procedures. consistent with Dr. Levine, a classic neck lift won’t address the jawline and jowls—it affects only the neck. “The difference is additionally within the incision,” she adds. “In order to reposition the lower face, there must be an anterior incision, meaning an incision within the front of the ear, also as behind the ear.” This incision are often extended above to also include lifting the cheek area. On the opposite hand, a neck lift includes incisions that are generally round the ears and below the chin. consistent with Dr. Madnani, for patients with minimal skin laxity, sometimes a neck lift are often performed just via an anterior approach- under the chin and may give fantastic results, especially when combined with liposuction. “A lower facelift can’t be addressed via this approach,” he adds.
“Most [good candidates for these procedures] need a lower facelift and a neck lift,” stresses Dr. Levine. Many patients require some correction to the neck and therefore the lower face since, anatomically speaking, the muscle extends from the lower face to the neck—it’s all connected. “In order to possess harmonious results and not [have] discrepancy between the face and neck, both should be performed,” adds Dr. Levine.
Dr. Rihani agrees: “When patients develop enough skin laxity to warrant a neck lift, many of them have enough skin which will probably need a lower facelift also ,” he says. However, for patients concerned about the situation of the incisions or for patients with only mild jowling, then a neck lift could also be performed alone. If the patient features a lot of visible platysmal banding, then a neck lift done under the chin, to bring the muscle bands together, is necessary—not a lower facelift.
On the opposite hand, the perfect candidate for a lower facelift may be a patient with some jowling but only minimal sagging or extra skin along their neck. Patients who need a lift along their mouth to correct laugh lines, additionally to lifting the skin round the jawline, are better fitted to a lower face-lift. Ultimately, the individual anatomy of the patient directs the doctor’s course of treatment.
Do the risks differ between the 2 procedures?
As with any surgery, there are risks to getting a lower facelift or a neck lift. Between them, the risks are very similar. “The main risk may be a hematoma, which may be a collection of blood under the skin,” explains Dr. Levine. “The patient should avoid aspirin, Advil, Motrin, and every one medications and supplements that cause increased bleeding [before surgery].” Dr. Madnani advises his patients to refrain from exercising, work (more than 10 lbs), bending over, or walking up many flights of stairs for 2 weeks after surgery to further reduce the danger of hematoma.
Patients should also stop smoking several weeks before the surgery. “This is vital to stop wound healing complications and necrosis, or death of the skin flaps,” explains Dr. Levine. Risk of injury to the facial is rare but possible, and Dr. Rihani warns that sensation within the skin could also be temporarily altered post-surgery. to assist ensure a positive outcome, these procedures should be performed by an experienced cosmetic surgeon who is conversant in facial anatomy.