Should a Facelift always include a neck lift?

Patients often ask me if they can avoid a face lift and just focus on the neck. The question is also asked the other way around: is it possible to have a facelift without a neck lift? This is my response:

With the advent of techniques that permit greater facial rejuvenation with less operating time and less risk of nerve injury (such as with the MACS lift), I believe that the neck should be treated with the face for a variety of reasons.

Aesthetic reason: The neck ages with the face. For example, they are both exposed to the sun in equal amounts (this assumes you don’t wear a turtleneck every day of the year!). It is a very rare case indeed (I’ve actually never had one) where the neck couldn’t benefit from surgical rejuvenation at the same time as the face. As I am already there, why leave it out of the equation when there is benefit to be gained?

Technical reason: If you are having the face lifted, then you need the neck skin to come up and re-drape over the jawline. It takes only a few minutes to undermine (elevate) the neck skin (I like using power-assisted liposuction with or without suction as needed). When elevating the cheek skin (I prefer the MACS lift) it is a simple extension of the surgical plane to enter the neck. After lipo undermining, this is very easy and quick. As the MACS lift is a pure vertical lift, it is a natural extension to bring the neck skin up to the jawline and at the same time elevate and tighten the platysma (the thin, flat muscle in the neck). I see little to gain by treating the neck without the face and vice-versa. Doing them together gives a much more natural look, which is what you want, right?

Give a jingle to our Stony Brook plastic surgery office if you’re thinking it might be the right time for some neck and/or facial rejuvenation. I promise we’ll guide you to the right decision for you.

To your health and wellness,

Dr. Mark Epstein

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