Neck lift is usually performed together with a facelift. This is because the excess skin of the neck is moved in an upward and outward direction which would increase the size of the jowl. Not all patients require a small minifacelift incision with a necklift, but most do so. Some patients who have had a previous facelift or are younger in their face with no jowl can have a surgical neck lift without an incision in front of the ears. In such cases a scar is only required behind the ear. In order to know what you would need, a consultation with Dr Sadove would be required.
Most of the examples of patients operated on by Dr Sadove in the facelift portion of this site also had the neck corrected at the same time. They all had what is called a “Corset Platysmaplasty”
Dr Joel Feldman in Boston described the operation in 1990. Corset platysmaplasty was developed to avoid postoperative imperfections. After the fat has been removed from under the skin and in some cases below the thin upper neck muscle, the two inside edges of the platysma are joined together with a continuous suture that runs down, and up, and down almost the full-height of the neck to create a smooth, flat, multilayered seam, leaving no free muscle edges to return as visible bands. Progressive side-to-side tightening along the midline seam defines the “waistline” of the neck
The main problem with Direct Excision Neckplasty is the scar. This is why so many experienced experts like Dr Sadove do not routinely perform this operation. It is more of value in older men who are willing to accept a visible scar on their neck or plan to wear a beard. Much less time and experience is required for direct excision and thus is less cost to the patients. The alternative is to move the excess skin is moved up and back to be trimmed from around the ears with only a small scar under the chin.