Neck Lift

The neck is a common area patients seek improvements in with surgery. Signs of aging in the neck are the result of loosening muscle and skin and sometimes the accumulation of fat. The medical literature recognizes youthful contours and angles to the neck and jawline which surgeons can strive for. However, all patients are not born with these features. In fact, there probably is no true "ideal" neck which every patient possesses in youth. There are many approaches to a neck lift. My approach is through a deep plane neck lift in the central neck in addition to a deep plane lift of the sides of the neck through the extended deep plane facelift. I feel this approach can provide the most comprehensive and longest-lasting improvements in the appearance of the neck. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. It is important to have a discussion with your surgeon about what can and cannot be accomplished with surgery to treat age-related changes to the neck. Tight Muscle and Skin Tight platysma muscle and skin contribute to a youthful-appearing neck. The platysma muscle is a long, thin muscle that wraps around the front and sides of the neck. It is weakest at the center. Most age-related changes to the platysma muscle occur when the center of the muscle weakens. This results in a separation of the muscle fibers from the center of the neck resulting in banding. Banding appears as thick, ropy folds in the center of the neck that can be more limited to the upper part of the neck or extend down low in the neck. The skin follows the loosening of the platysma muscle. Sharp Angle between the Jawline and Neck The angle between the more horizontal jawline and the more vertical neck is called the cervicomental angle. An aesthetically "ideal" angle is acute, with the soft tissue under the jawline tucked up between the jaw bones and the skin and platysma muscle tight against the neck. Age results in a blunting of the cervicomental angle, regardless of where it started. This can be due to loosening of the platysma muscle resulting in banding, the accumulation of fat deep to and superficial to this muscle, and loosening skin. The horizontal location of the soft tissue – whether it is tucked up under the jawline or rests below it – is dependent on the patient's natural anatomy. Some individuals may have more soft tissue that sits below the jawline from an early age. Visible Thyroid Notch The thyroid notch is a small depression above the cartilage, called the thyroid cartilage, and below the cervicomental angle. It is less visible in women versus men because men have a more prominent thyroid cartilage. The thyroid notch reflects the tight attachment of the soft tissue of the neck just below the cervicomental angle. Loosening of skin and muscle in the neck due to aging reduces the appearance of the thyroid notch. Tightening of the muscle and skin can improve the appearance of it. Every Neck is Different Every individual is born with different neck features. Some individuals were born with a sharp cervicomental angle and little soft tissue hanging below the jawline. Others were born with a blunter cervicomental angle and, therefore, a more poorly defined neck. A blunted cervicomental angle can be due to the location of a bone, called the hyoid bone, which sits above the thyroid cartilage. When the hyoid bone sits up and back in the neck a sharper cervicomental angle is possible. However, some individuals are born with a hyoid that sits down and forward, creating a naturally more blunted cervicomental angle. All the deeper muscles of the neck radiate from this bone, which is what sets the cervicomental angle in the first place. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! CONTACT US

Neck liposuction and a neck lift procedure each address specific concerns about the neck and the area under the jaw. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Changes Can Occur in All Layers of the Neck Changes can occur at all layers of the neck with aging. The skin and muscles of the neck loosen, forming bands. Fat accumulates immediately below the skin and deep to the neck muscles. These changes can cause the jawline to lose definition and the neck to appear poorly defined. Neck Liposuction and a Neck Lift are Two Options for the Neck Individuals who present with concerns about their neck and/or the area under their jaw may benefit from either neck liposuction or a neck lift procedure. However, a detailed history and physical exam should always be performed prior to making this decision. Neck Liposuction Alone May Be Good for Younger Individuals Neck liposuction, which involves the careful placement of small incisions hidden under the chin and sometimes behind the earlobes, can be a good option to treat patients who have accumulated fat close to the surface of their skin but with minimal skin and muscle changes. Neck liposuction tends to be a better procedure for younger individuals. This younger patient demonstrated excess fat across her neck and the area under her chin, called the submentum. No excess skin or loose muscle was present. This patient was an excellent candidate for neck liposuction only. She could not be happier with her results only one week after surgery. This younger patient demonstrated excess fat only in the area immediately under her jaw, called the submental area. As a result, she desired a more subtle result. She is thrilled with her results four months after surgery. A Chin Implant with Neck Liposuction Can be a Powerful Procedure for Other Younger Individuals Some people not only have lost definition of their jawline and neck over time but also have a poorly-defined chin. A chin that does not project out adequately relative to the lips and nose can exaggerate the appearance of the jawline and neck. That is why a chin implant and liposuction can be so powerful when paired. The patient of ours below is an excellent example of this. This younger patient not only had concerns about the lack of definition to her jawline and neck, but also demonstrated a weakly projected chin. She received a small chin implant that contoured naturally to her jawline in addition to undergoing liposuction under her jawline and neck. A Neck Lift May be More Appropriate for More Complex Changes A neck lift is meant to address more complex changes to the neck more comprehensively, including the skin, muscle, and both superficial and deep fat. The superficial neck fat is usually removed under direct visualization with specialized instruments during a neck lift in Cincinnati. Performing only liposuction, especially aggressive liposuction, on an individual who is experiencing more complex age-related changes to their neck increases the risk of the skin scarring to the hanging muscle bands, worsening the appearance of the banding. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the neck and face when you have concerns about your neck and/or the area under your jaw. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us

The core of any facial plastic surgeon's skills come from their training in fellowship, which follows their residency training. The premier body for fellowship training in facial plastic surgery is the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Established surgeons learn from their colleagues by visiting them in the operating room and by engaging with them through medical literature and at meetings. True advancements in surgical techniques are more likely to be published in reputable journals than kept within the surgeon's operating room. Moreover, these advancements usually improve upon previous innovations in an iterative process where the wisdom of a surgeon's colleagues is built upon. Those surgeons who advanced early facelift techniques (e.g., Suzanne Noel) set the stage for improvements based on an evaluation of the strengths and weaknesses of those techniques and an improved understanding of the anatomy of the face and neck. No truly innovative technique ignores history. The deep plane facelift as developed by the plastic surgeon Dr. Sam Hamra (1, 2, 3, 4, 5) was a combination of the advancements made by previously developed techniques, specifically the SMASectomy facelift, and new understandings of facial anatomy. The extended deep plane facelift, a technique developed by my AAFPRS fellowship director Dr. Andrew Jacono, advanced upon the deep plane facelift technique as developed by Dr. Sam Hamra (6, 7, 8, 9). This blog post seeks to explain the differences between the deep plane facelift and extended deep plane facelift. As a result, this blog post will explain why these techniques were such an incredible improvement on previous facelift techniques. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Deep Plane Facelift Does Not Address the Side of the Neck The most significant difference between the deep plane facelift and the extended deep plane facelift is that the deep plane facelift does not address the side of the neck in a deep plane. In contrast, the extended deep plane facelift "extends" the deep plane facelift technique into the side of the neck (6, 7, 8, 9). This involves the release of tension points called cervical retaining ligaments that restrict the ability to tighten the muscle around the neck surgically unless released, much like the two important ligaments in the face and jawline released during deep plane facelift surgery. The Extended Deep Plane Facelift Can Speed Up Recovery One relatively minor difference between the two techniques as described in the literature makes a potentially large difference on the length of recovery. The initial description of deep plane facelift involved lifting the eye muscle itself. This can sometimes result in more prolonged swelling around the eyes and increases the risk of temporary weakness in the eye muscle at this location. In contrast, the extended deep plane facelift goes over the muscle, preserving its continuity, thereby decreasing the risk of prolonged swelling and temporary muscle weakness around the eyes. Dr. Harmon is One of the Few Surgeons in the World Fellowship Trained in the Extended Deep Plane Facelift by Dr. Andrew Jacono The extended deep plane facelift requires extensive training to perform. Dr. Harmon is one of the few surgeons in the world – and the only surgeon in the Cincinnati, OH area – trained in the extended deep plane facelift by its creator, Dr. Andrew Jacono. As a result, he is uniquely qualified to perform this technique both for a first facelift and for a secondary/revision facelift on patients who have undergone a facelift with other, older techniques in the past. As always, an in-person consultation is important to understand whether the extended deep plane facelift is appropriate for an individual. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching "plastic surgery near me." Get in touch with us to learn more. Contact Us References Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990 Jul;86(1):53-61 Hamra ST. Composite rhytidectomy. Plast Reconstr Surg. 1992 Jul;90(1):1-13. Hamra ST. Composite rhytidectomy and the nasolabial fold. Clin Plast Surg. 1995 Apr;22(2):313-24. Hamra ST. Composite rhytidectomy. Finesse and refinements in technique. Clin Plast Surg. 1997 Apr;24(2):337-46. Hamra ST. Building the Composite Face Lift: A Personal Odyssey. Plast Reconstr Surg. 2016 Jul;138(1):85-96. Jacono AA. Face-Lift Surgical Techniques. Facial Plast Surg Clin North Am. 2020 Aug;28(3):xv-xvi. Jacono AA. A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline. Facial Plast Surg Clin North Am. 2020 Aug;28(3):331-368. Jacono AA, Alemi AS, Harmon JJ, Ahmedli N. The Effect of a Novel Platysma Hammock Flap During Extended Deep Plane Facelift on the Signs of Aging in the Neck. Aesthet Surg J. 2022 Aug 1;42(8):845-857. Jacono A, Bryant LM. Extended Deep Plane Facelift: Incorporating Facial Retaining Ligament Release and Composite Flap Shifts to Maximize Midface, Jawline and Neck Rejuvenation. Clin Plast Surg. 2018 Oct;45(4):527-554.