Recreating a more youthful neck

Other than droopy eyelids, there is nothing that will make you look older than jowls or a crepey, wrinkled neck. It doesn’t matter how smooth and glowing your facial skin appears, an aged neck is an instant giveaway that is hard to camouflage.

How your neck ages will depend on your genetic composition, your skin type and lifestyle (whether you smoke or have had too much sun).

Restoring the skin surgically to its former youthful, taut texture is the key to a defined jawline. One of the first, tell-tale signs of an ageing neck is when the facial tissues and muscles droop and result in jowls. This blurs the transition from face to neck. Fatty neck deposits create a double chin and jowls, while the platysmal muscular bands produce ridging along the neck contour. These ridges are initially temporary and only present during animation such as smiling, laughing or shouting. However, they become permanent with the passage of time.

Each patient will have their own combination of problem areas, so addressing the neck has to be individualised. To re-establish a defined jawline obscured by jowls, an SMAS-based lower facelift and necklift, which involves removing excess skin and tightening the underlying muscles to realign them, offers the most effective treatment.

A necklift is rarely performed in isolation as the face and neck need to be in perfect harmony for a believable result. There is no point having a more youthful looking face supported by a neck marred by wrinkles and extra folds of skin or vice versa.

The surgical solution generally involves a neck and lower face lift.
The facial plastic surgery treatment involves resuspending the skin and muscles to restore the angle between jaw and neck. Liposuction to remove any excess fat is done through incisions concealed in the hairline beneath the ear and occasionally beneath the chin. The key factor is to avoid removing too much fat, which can leave the patient looking gaunt and hollow. While there is a general tightening of all the tissues, the end results will not look restricted or stretched.

Bruising is the main drawback, but this can be concealed with make-up or clothing until it resolves over the following 1 to 2 weeks. Occasionally swelling beneath the chin may persist for several weeks necessitating the use of a pressure garment to hasten recovery.

Even young people can have muscular bands or deep horizontal lines on their necks that can be treated non-surgically with anti-ageing injections – thus delaying the need for surgery.

Skin texture and even skin tone will also need to be addressed when aiming for a youthful neck so I find Fraxel laser treatments which stimulate the growth of new collagen most effective. It also helps remove excess pigmentation and soften fine lines and is the most effective non-surgical either stand alone or adjunct treatment to surgery to further enhance the end result so it looks as natural as possible.

A seamless smooth contour from jaw to neck, if done well, could easily take 10 years off your appearance. The end result should re-establish facial harmony, without looking tight or stretched – but instead look completely natural.


No one needs a neck lift but the patients who benefit most from neck lift surgery have thick, fatty necks or too much loose neck skin. Neck lift surgery also corrects the muscular bands some patients develop in their necks. These are called platysmal bands.

Neck lift surgery is tailored to your needs as an individual patient. Patients with fatty necks benefit from liposuction to the neck. Patients with prominent muscular bands benefit from division of the bands, and patients with excess neck skin need to have their excess neck skin removed.

The main problem that can occur after neck lift surgery is prolonged swelling. This is managed by a compression garment and over a period of weeks it subsides. Bleeding and nerve injury can also be problematic after neck lift surgery, but thankfully neither are common.

One to two weeks downtime is usually all that is required after neck lift surgery. Thereafter the compression garment can be worn at night time and you can ease back into your usual routine.

Depending on the extent of the surgery your scars will either be confined to the underside of the jawbone, or around the ear or both. The scars around the ear are very well camouflaged by the natural contours of the ear. If liposuction is all that is required then two small scar measuring 2-3mm each will be all that is required. They are located under the jawbone. Finally a direct neck lift is very effective but involves a long vertical scar extending down the neck. While all scars fade in time and ultimately become difficult to see, this vertical scar is the least well concealed.

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