Targeted neck treatments in plastic surgery
Many people want to improve the appearance of their neck without resorting to the concept of a facelift. Getting rid of the chin on the neck would give them a younger look and they could wear ties, turtlenecks or jewelry more comfortably. The fear of a facelift is nearly universal. Whether you feel you are too young or too old for surgery, don’t have time for significant recovery, or can’t afford it, many potential patients are drawn to any procedure or method that offers an alternative.
Some fuller necks or neck watts may benefit from a treatment directed at the neck only. Such neck rejuvenation, known as submentoplasty, only works on the neck by removing fat and tightening muscles. No incisions are needed around the ears, unlike traditional facelift surgery.
As we age, definition and smoothness are lost under the chin and along the jawline. This occurs due to fat deposits, weakening of muscles, and the appearance of loose skin. This results in the obliteration of an acute angle of the neck, where the neck and chin meet. Often this becomes a straight line sloping obliquely downward from the chin to the bottom of the neck.
The skin on the neck is different from the rest of the skin on the face. It typically has much more elasticity and can actually contract or shrink up after being released from the underlying muscle and fat. Since the skin on the neck sits on the underside of the chin, many would think that it would droop down and hang more after being released. But this usually doesn’t happen unless the skin on the neck is paper thin.
The submentoplasty procedure is performed through an incision under the chin. First, the removal of fat in the neck is done with liposuction. This is followed by a tightening of the platysma in the midline and a wide release of the neck skin from the muscle. Whether just liposuction or the full submentoplasty procedure is needed will depend on the age of the patient and the quality and amount of loose neck skin that is present.
Younger patients (under 35), who generally have more skin elasticity and have rough skin due to too much fat under the skin, usually only need liposuction. Middle-aged patients (35 to 55 years) also have fatty deposits, but in addition have loose or cracked skin and plastismal neck muscle. This requires the full submentoplasty method of treatment. Older patients (over the age of 55) almost always need extensive neck reshaping and a facelift where loose skin is removed.
In my experience with plastic surgery in Indianapolis, I have found that proper neck rejuvenation for many patients requires some version of a facelift. But age is a key factor in determining the suitability of a submentoplasty. In patients under the age of forty-five, approximately half of them can achieve good results with a submentoplasty and avoid a facelift. However, after the age of forty-five, that number drops to less than one in ten. And after the age of fifty-five, that number is essentially reduced to zero.
While submentoplasties are a primary treatment for certain neck problems, they can also be used as a secondary cosmetic surgery after a facelift. Some facelifts, particularly with very low necklines, will often elicit some rebound relaxation in the submental region that is furthest from the point of pulling the skin back at the ears. A submentoplasty allows for further refinement of the neck when the results of the facelift begin to relax.
A submentoplasty is a simple one-hour procedure that is performed on an outpatient basis. Aside from wearing a chin strap for a few days, recovery is quick in a week or less.