Sagginess of the neck, loss of neck contour, formation of neck bands, a lump under the chin (double chin) and jowls can occur at any age although ageing is a common cause.
A double chin and the loss of neck contour could be a familial presentation. Contrary to popular belief excess fat is not usually the cause of these problems. None of these patients need liposuction. We have found out over the years that liposuction in these areas produces skin irregularities with an unpleasant looking neck. These patients usually also have a retruded chin.
For a named procedure each surgeon's technique is different and it is always advisable to ask what is involved in a particular operation.
The surgical options are simple platysmal plication, neck lift with platysmal plication, chin implant or genioplasty with platysmal plication and neck +/- face lift.
This procedure will improve the neck contour and eliminate the neck bands without removing any skin. We published our technique in 2005 (Sabesan T, Ilankovan V Platysmal Plication: Technical note British Journal of Oral & Maxillofacial Surgery, June 2005). We make three incisions. A 2 cm incision is made along the crease under the chin and a 1cm incision just below and behind the earlobe. The muscle is dissected free from the skin. Midline corset-type sutures are placed to approximate the platysmal muscle in the midline. A further two sutures are placed which are tunneled to the earlobe and, after further imbrication, the sutures are anchored to the area behind the ear. This procedure is done under a local anaesthetic and takes about one hour. The fee is £1,000.
The aim here is to free the platysma muscle, which acts like a curtain in the neck, entirely from the skin. The muscle is then repositioned and anchored in the midline and laterally. The skin is draped back and the excess skin is removed. A support garment is placed. The surgery is usually carried out under a local anaesthetic as an outpatient and takes approximately 2 hours to perform and you are sent home with the necessary support.
A 2cm skin crease incision is made under your chin. A further two incisions are placed in front of the earlobe which travels behind the ear with a 45 degree extension into the scalp. The platysma muscle is entirely dissected from the skin. Via the chin skin crease incision the platysma is approximated in the midline using fine sutures. The corset-type suturing will prevent any further fat herniation. Platysmal plication will be carried out then the excess skin is removed in front and behind the ear and the scalp.
We always perform a neck lift as part of a face lift however not all patients need a facelift. We also perform a neck lift with our lunchtime lift.
The beauty of a neck lift is the limited downtime, it is a local anaesthetic procedure, half the expenditure and the procedure is carried out as an outpatient. The price varies from £2,000 to £4,000.
In suitable patients a chin implant can be placed via an incision inside the mouth with simultaneous platysmal plication.
We prefer an intra oral incision so that the implants are placed very accurately without any tension. For further details I would refer you to our chin surgery section.
Chin implants can also be carried out as part of a neck lift.
The recovery from each procedure is approximately two weeks. The sutures are removed after about seven to ten days. You can return to work usually at the end of the second week. The approximate expenditure is £2,500.