Consider Custom Solutions for a Sagging Neckline
Necklines for both men and women can be a focal point of self-consciousness.
However, the etiology of an unattractive neckline can be diverse, so treatment
options must be tailored to the underlying cause. There is no one
solution for everybody. Careful three-dimensional analysis of the soft
tissue and underlying bony structure of the midface, lower jaw and neck are
imperative to choosing the correct modality to improve your neckline.
Some common underlying causes of poor aesthetic necklines:
Small lower jaw - If you have a deep underbite despite
orthodontics and a short chin, this leads to less bone support of the soft
tissues of the jawline and submental region. People with this type of lower jaw
may have a very obtuse chin-neck angle leading to redundant skin. An ideal
treatment for this situation is bony chin advancement (genioplasty).
If your chin is horizontally too short, then an augmentation with a chin
implant is an excellent choice. I prefer the Medpore implant, which is carvable,
and screw fixated and becomes an extension of the bone.
Both genioplasty and chin implants can easily incorporate the technique of
liposuction as a means of sculpting the soft tissues of the neckline by removing
unwanted fat. Liposuction induces collagen production and facilities skin
shrinkage and redistribution yielding a pleasing result. This combination
therapy can produce a wonderful outcome that makes you look more facially
balanced. However, if your skin is too loose and hanging, a more formal neck
lift may be preferable to liposuction.
Mid face descent of soft tissues - Aging can affect facial
fat compartments leading to decreased volume, which results in the midface
falling over time. This sagging increases nasolabial folds and causes lower
facial soft tissue to drape over the jawline. A crisper jawline can be restored
by replacing missing soft tissue volume in the fat compartments of the midface
with filler agents like Voluma and Sculptra or via fat grafting. Subtle volume
enhancements can create a nice effect on the jawline without looking like you've
undergone a surgical procedure.
Gravitational changes to the soft tissue of the neck -
Gravity affects all of us. The skin and muscles of the anterior neck begin to
pull away over time. The appearance of the platysma muscle medial bellies
becomes apparent leading to unsightly banding. In the early stages of
gravity-induced changes, treatments such as chemical peels, micro-needling and
radio frequency can yield improvements and delay the inevitable soft-tissue
sagging.
Ultimately the best treatment option is a face/neck lift. A well performed
facelift by an experienced board-certified plastic surgeon will yield excellent
results with longevity of up to ten years depending on how well you age forward
and take care of your skin, avoiding further sun damage.
Obesity - People with elevated body mass indices will
accumulate increased fat throughout the body. The neck is no exception. Very
mild amounts of fat excess with firm, good quality skin may realize improved
contours with Kithera (an injectable product that dissolves fat in the neck).
However, in my experience, few patients I evaluate are ideal candidates for this
treatment. The injection results in inflammation, which can cause collagen
production and skin remodeling, but most people need bigger guns to fight the
battle. The price of several rounds of injections is as much as a true
liposuction with less effective results.
If you have significant fat in the submental region and reasonable skin
quality, liposuction can be a great treatment option to uncover a more normal
neckline without a lot of expense or downtime. However, a face/neck lift with a
corset platysmaplasty is the tried and true corrective option that works very
predictably.
If you're obese and undergo bariatric surgery or make lifestyle changes to
produce massive weight loss, you'll likely develop excess deflated skin that
hangs off your face and neck creating an aesthetic deformity. Modifications of
standard face and neck lifts must be incorporated to achieve a pleasing
result.
The takeaway is that if you're unhappy with your jaw and neckline, you can
improve your appearance and boost your self-confidence by seeking out proper
consultation with an experienced plastic surgeon. During the consult, a detailed
facial analysis should be performed. Treatment options can be formulated to
yield the best results by addressing your unique issues as presented during the
interview. No need to hide your neck behind scarves and turtlenecks any longer.
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