Recently, there has been a surge in inquiries about neck lifting. Many international patients visit me saying things like, "I had liposuction on my double chin, but it didn't work," or "My deep neck wrinkles and sagging skin make me look older than I am."
Today, I would like to clarify exactly what a neck lift procedure improves by sharing the stories of two male patients who traveled from the United States and Australia to see me. We will compare their cases to determine which surgical method is right for your specific condition.
Why Double Chin Liposuction Fails (The Anatomy)
Many patients consider submental liposuction the first step in fixing a double chin or fatty, sagging neck. However, many end up contacting me for revision surgery because the area is still bulky or the skin is lumpy.
The reason is simple. The problem isn't just the "fat under the skin."
The human neck consists of complex layers. Beneath the subcutaneous fat, which liposuction removes, is a thin muscle called the platysma. Deeper still are deep fat pads, the digastric muscle, and the submandibular gland.
(The numbered order goes from shallow to deep)
Simple liposuction cannot address these deep structures. To achieve a sharp, defined jawline, proper cosmetic neck surgery that addresses these layers is essential. This type of surgery is called a Deep neck lift.
Mini Neck Lift vs. Full Neck Lift: The Critical Difference
Depending on the incision and dissection range, deep neck surgery can be categorized as a Mini neck lift (short scar) or a Full neck lift. The right choice depends on your skin elasticity, skeletal structure, and how much time you have for recovery.
Let's look at two recent cases to better understand this.
Case 1: 50s Male from the USA (Mini Neck Lift)
This patient was self-conscious about the sagging appearance of his neck and wanted a sharper, more masculine jawline. Due to his skin laxity, I initially recommended a full neck lift or a facelift. However, his vacation schedule was short, and he could not afford a two-week recovery period.
Dr. Park's plan: Respecting his desire for a quick recovery and his intention to have a facelift in a year, we proceeded with a Mini neck lift.
I performed Corset platysmaplasty (neck muscle tightening) and deep fat removal through a small incision under the chin to create a defined jawline. We didn't fully excise the loose skin this time, but he plans to return to Korea next year for a facelift to address the sagging skin in his neck.
Case 2: 40s Male from Australia (Full Neck Lift)
After extensive internet searching, this patient found Noonopi Plastic Surgery. He carefully planned his lifting neck surgery, staying in Korea for over a month. After visiting several clinics, he chose to proceed with us following our consultation. Initially, he thought he needed a "Mini" lift as well.
Dr. Park's plan: The patient had a retruded chin and sagging skin had already started. When the chin bone is small, the neck skin lacks support and begins to sag earlier.
I determined that a simple mini lift would not be effective because it could not remove the excess skin. Therefore, I recommended a Full neck lift to significantly improve the sagging skin and vertical neck bands.
Deep Neck Lift: Specialized for Double Chin Correction
(Reference: Short Scar Neck Lift Using a Submental Incision Only)
A small incision (about 3-4 cm) is made under the chin for the mini neck lift. The advantages are minimal scarring and a quick recovery. This procedure is ideal for individuals with good skin elasticity or those requiring a swift return to their daily routine. Unlike neck liposuction, this technique removes deep neck fat.
(Reference: Corset Platysmaplasty)
However, in some cases, removing fat alone might reveal bulging salivary glands, which would make the result look incomplete. In such cases, the Submandibular glands must also be reduced.
4 Customized Techniques at Noonopi
At Noonopi Plastic Surgery, I use four customized techniques, depending on the individual:
- Deep Fat Removal: This involves removing fat located under the platysma muscle.
- Gland reduction: Reducing enlarged submandibular glands that appear as bulges after fat removal.
- Digastric muscle shaving: Trimming the muscle to create a sharper angle under the chin.
- Corset platysmaplasty: Tightly tying the separated platysma muscles like a corset. This prevents the double chin from folding, even when looking down.
Can Mini Neck Lift improve skin sagging?
To some extent, yes. As the volume of the double chin decreases, the surface area of the neck increases. This allows the excess skin to redrape and tighten, as shown below.
Full Neck Lift: Addressing Sagging Skin & Wrinkles
However, if the sagging is severe, such as in the case of the Australian patient or due to aging or a weak chin, a mini neck lift is not enough. Even if we reduce the contents (fat or muscle), the skin remains loose and wrinkly.
A Full neck lift includes all the techniques of a mini lift, such as deep fat removal and platysma tightening, but it also involves making an incision behind the ear.
Why is the incision made behind the ear?
Cutting excess skin only from under the chin leaves a visible scar. By making an incision along the hairline behind the ear and pulling the remaining skin backward, we can trim it along the hairline. This method provides excellent neck lift results while hiding the scars behind the hair and ears.
Is Submandibular Gland Excision Necessary?
Recently, submandibular gland excision has gained attention among Korean plastic surgeons. I consider gland correction to be an essential part of the neck lift procedure.
Why is it necessary?
Bulges on both sides of the jaw often remain even after deep fat removal or neck muscle platysmaplasty. This "bulge" is often the enlarged gland itself.
Is gland removal safe?
We have multiple salivary glands, such as the parotid and sublingual glands. Removing a portion of the submandibular gland for cosmetic purposes is safe because other glands compensate for its function, so issues like dry mouth rarely occur.
Conclusion
The patient from the United States returned home happy with his sharp, masculine profile. The patient from Australia was delighted with the dramatic results of his full neck lift after careful comparison.
Neck lifting is not just about tightening the skin. It is a complex surgery that addresses deep fat, muscles, glands, and the patient’s skeletal structure.
If you are troubled by an aging or blunt neckline, contact us for a consultation.
Dr. Nk Park Noonopi Plastic Surgery, Seoul.
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