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Nagged by a Fleshy Neck?

Transform sagging skin into a swan-like neckline

Recently during a conversation with a few women friends of mine, the topic turned to our on-going aesthetic treatments and wish lists for future work to enhance and maintain our beauty. The general consensus was that although most of us are pretty satisfied with our general appearance, we are beginning to notice that our necks seem to be aging faster than our faces. A couple of my girlfriends, who have lost a lot of weight, now seem to have a new obsession with the loose skin that has replaced the fat that once inhabited their faces and necks. One of the older women in the group recently had a face-lift, and while the skin on her face is taut, supple and relatively line-free, from the chin down, it’s a different story.

For many people, the neck is the first area to show age. For those who have lost weight, an unfortunate side effect may be leftover, loose-hanging skin that has lost elasticity. While there are several non-invasive treatments that can help improve the texture and tone of facial skin, not so for the neck. No amount of anti-aging cream, no matter how pricey, can lift loose neck skin. This usually requires in-office treatments, or even surgery. Whether your issue is band lines (also known as “turkey wattle”), excess skin or fat, a neck lift can bring your neck back into shape. The procedure can be performed in a variety of ways, depending on your individual issues and expectations.

Three possible neck lift procedures include: Cervicoplasty, Platysmaplasty and Liposuction.


The most common cause of a saggy neck is loose skin, which is many times hereditary and can be more pronounced after rapid weight loss. For loose skin (if you can pinch an inch of the skin on your neck or jaw line), cervicoplasty may be your most effective option. A plastic surgeon can tighten and remove the extra skin by making incisions in front of and/or behind each ear. The excess skin is pulled back and stitched in place with permanent sutures or a special type of permanent adhesive glue. An elastic bandage will be applied to your neck and head. Typically cervicoplasty is done under general anesthesia, but, depending on your level of comfort, you may elect for local anesthesia.


In some cases, a muscle in the neck (platysma) causes sagging. When the platysma contracts and tightens, it produces vertical muscle bands that run from the jaw to the collarbone. Over time, these muscle bands may pull on the skin, and produce sagging and looseness. This is most noticeable under the chin. In mild cases, Botox injections can be used to relax the muscle bands and smooth the neck. However, treatments are temporary and must be repeated every four to six months to maintain the result.

If there is prominent sagging of the platysma muscle, a surgeon can make small incisions under the jaw line, or behind the ears, or both. The surgeon will then insert a tiny instrument to either remove a portion of specific neck muscles or realign them, which will tighten the middle area of the neck. The doctor will permanently suture areas of the muscles in order to clasp them in the best position. A bandage and tape will be applied across the chin or behind the ears to reduce swelling and discomfort. An elastic bandage will be wrapped around the neck and head. Platys­maplasty can be done under local anesthesia, but you can request general anesthesia if you want to be asleep during the procedure.


If your neck lift requires liposuction to remove excess fat, the liposuction procedure is typically performed first. An incision will be made below the chin to remove the excess fat deposits. Fat deposits will be removed by inserting a small cannula (a hollow tube with an opening near its blunt end) beneath the skin and into the fatty tissue. The cannula is used to break up the fat, and then remove it from the neck area. A bandage will be applied to reduce swelling and discomfort. The doctor may also apply a bandage around your neck and head.

How to Prepare for a Neck Lift

What do you dislike about your neck? Be honest with yourself to make sure you get the results you want. Write down your thoughts on what you’d like to correct and have your list with you at the time of your consultation.

During the consultation, your surgeon will instruct you on what medications to avoid prior to your neck lift. Certain medications and vitamins thin your blood and can cause increased bleeding. If you are a smoker, you will need to quit at least two weeks before surgery and two weeks after. You cannot just plan to cut down. You must not smoke for this time period to ensure proper healing.

Also, this is no time for a diet: make sure that you eat properly because this will help your body heal. Wear loose, comfortable clothing on the day of surgery, such as a button-down blouse or shirt, that does not have to be pulled over your neck or head. Plan to take at least one week off from work to recover, maybe more. Your doctor will help you determine this based on your
personal situation.


Your neck, jaw and ears may be bruised and may continue to swell for up to 10 days. The doctor may suggest using two pillows when you sleep. The physician will also recommend keeping your head and neck still and elevated at all times for up to 10 days.

Oral pain medication and an antibiotic can be administered to reduce pain and reduce the risk of infection. Severe pain or abnormal symptoms should be reported to the doctor immediately. The doctor will set dietary guidelines and instruct you to limit physical activity. Exercise may be restricted for a short period of time.

The bandage around your neck and head typically can be removed the day after surgery. However, an elastic-type garment must be worn throughout the evening for at least two weeks. Stitches may be dissolvable, or will require removal up to seven days after the procedure. Final results will be evident in about three to six months.

Complications and Side Effects

Swelling and bruising will last for several days after a neck lift. You may feel tightness or tingling, and different sensations including burning or pulling. You also will experience numbness. These are all very normal in the first few weeks following surgery and should not be cause for concern.

As with any surgery, you run the risk of infection. Keep a watchful eye on your temperature. At the first sign of a fever, contact your doctor. If you have unusual discharge from the incision site, consult your doctor immediately.

Although it’s very rare, you could have an allergic reaction to the anesthesia. That’s why it’s very important to disclose any drug allergies to your doctor during your initial consultation.

Does Insurance Cover Neck Lifts?

Insurance carriers are all different, but one thing is the same: They typically do not cover elective, cosmetic surgery.

If your procedures will in any way correct a medical condition, you must express this to your insurance carrier. Your surgeon can write a letter detailing your case.

Also, it’s important to realize that cosmetic or plastic surgery can affect future coverage under certain insurance carriers. It can also affect your premiums. Be sure to ask your insurance carrier about how your future coverage or premiums will be affected if you undergo any of these procedures.

Neck Lift Cost

Since a neck lift may require more than one procedure, costs can vary. A neck lift may be performed along with a face-lift, forehead lift or eyelid surgery. Average neck lift costs range from $5,000 to $8,000. If the cost is too much to pay at once, ask your surgeon about monthly payments. These arrangements are fairly common.

If you’re not interested in surgery, or the idea of needles makes you queasy, try this exercise I learned from a yoga teacher who has a neck like a swan: curl your tongue up and back, pressing it against the roof of your mouth. Hold for a few seconds and repeat. Do this a few times a day. You can do it in the car or while you’re sitting at the computer. The contractions will help keep your jaw muscles firm and prevent more sagging.

In many cases, more than one factor is responsible for a sagging neck, and a combination of procedures may be necessary. Consult with a plastic surgeon who will evaluate your neck, assess your expectations and recommend the best treatment for you.

By Cheryl Alexander

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