Many patients say they are unhappy with the appearance of their necks. A combination of skin character, laxity, fat accumulation, and descent of structures due to ageing and gravity result in the typical aged neck appearance. The skin wrinkles, becoming lax, the muscles tighten up in some parts giving rise to unattractive bands, fat accumulates in the subcutaneous planes and the submandibular salivary gland may become more prominent. These processes lead to loss of the sharp defining angles of the neck – the ‘turkey neck’, as it is known, comes to replace the ‘swan’s neck’. For many patients this is the main area of complaint.
A youthful and ideal neck is often presented as taut, slim and angular and is defined by its sharp borders, most notably at the jowl line, as well as the cervicomental angle (the jaw-to-neck transition at the Adam’s apple). The neck is made up of the same basic structures that define the face:
- a skeleton, which is more sparse here and is only represented as bony anchors (the lower border of the jaws, the Adam’s apple and the collar bone);
- skin and subcutaneous fat;
- the superficial musculo-aponeurotic system (SMAS) or mimetic muscles of facial expression (platysma, the muscle that causes the banding of the neck); and
- deeper structures such as the submandibular gland.
Facial harmony and rejuvenation is one of Dr Farhadieh’s areas of special interest and training. He has recently co-authored plastic surgery textbook chapters on this topic.
Various approaches have been used to address these problems and Dr Farhadieh will discuss what would be best suited to your needs. Where a small incision under the chin is needed, the skin’s natural creases can camouflage it. An incision around the ears allows access to the neck. This incision is often an extension of the facelift part of the operation. It is important that in any rejuvenation approach to the neck and face, the whole is considered. A piecemeal approach to facial rejuvenation at the very least sacrifices harmony in favour of addressing one small part, bringing other problem areas into sharper focus.
A combination of mimetic muscle manipulation, fat resection and redraping of the neck with excision of this excess skin results in a rejuvenated appearance, re-establishing the sharper and well-defined angles of the neck and jaw.
The operation is performed under general anaesthetic with an overnight admission. After discharge, a follow-up appointment is made 5–7 days postoperatively. Some swelling and bruising is to be expected, but this usually resolves by the end of the second week. Your relationship with your surgeon is the most important aspect of this journey. We are dedicated to being there with you for every step of the journey.
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’
Frequently Asked Questions
Will I need general anaesthesia and overnight admission?
Yes, neck lift surgery is intricate surgery, which deals with the face and neck. General anaesthesia and overnight admissions are the safest way to undertake this surgery.
Will the scars be visible?
Immediately after surgery, yes, but the incisions are placed in such a way that once healed they will not be visible or noticed. From time to time, scar abnormalities or some skin loss might occur as a result of surgery. These can be managed conservatively, occasionally requiring secondary surgery.
How long will the recovery take?
This can vary from patient to patient. The majority of swelling resolves within the first 7–10 days. Most patients are out and about by the end of the second week. Any remaining swelling is usually gone within 4 weeks.
Is asymmetry following surgery common?
All humans have some intrinsic asymmetry to their face and body, and in adequately trained hands noticeable persistent postoperative asymmetry is rare. Occasionally the lower branches of the facial nerve are bruised during surgery, but this tends to recover within a matter of weeks.
Can any surgeon perform facelift surgery?
The face and neck are amongst the most intricate parts of the body and their importance in projecting our sense of ‘self’ is clear. Performing neck lift surgery is often thought of as a subspecialty amongst plastic surgeons and those who are interested seek further training beyond basic plastic surgical qualifications. Dr Farhadieh has an interest in facial surgery and has undertaken two separate clinical fellowships in London, England, focusing on the face from both cosmetic and reconstructive perspectives. You are in the safest and best trained hands with us.
What will my follow up include?
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-ups as part of our overall practice.