What Is the Best Age for a Neck Lift?

Anthony MacQuillan MBBS MD FRCS(Plast)

Determining the Best Age for a Successful Neck Lift Procedure

You may have noticed that as you age, certain areas of your body start to sag or droop, with your neck being a prime example. This can be a cause of concern for many, as it alters the way you look and feel about yourself. One solution to this issue is neck lift surgery, a popular cosmetic procedure that helps to improve the appearance of your neck.

This surgical procedure can be a great way to regain a youthful appearance. However, like any other surgical procedure, it requires careful consideration and understanding of the process. You might be left with questions like, “What is the right age for neck lift surgery?”, “What are the risks involved?” or “How should I prepare for it?” In this blog, Consultant Plastic Surgeon Anthony MacQuillan will answer all these questions and more.

The Process of Ageing and Its Effects on the Neck

The ageing process is a natural phenomenon that everyone goes through. It’s a complex process that involves numerous biological changes in the body. As you age, the skin loses its elasticity and firmness, leading to sagging and wrinkles, especially around your neck. This can make you appear older than you are.

The neck is particularly susceptible to ageing. This is due to the thinness of the skin in this area, coupled with its frequent exposure to the sun and environmental pollutants. Less well appreciated however is the fact that over time, the anatomy of the neck changes. The muscle directly beneath the skin, called the platysma, starts to become unstuck from the deeper tissues of the neck and then begins to bowstring – taking the shortest route from the chin to the clavicle (collar bone) – as a muscle will always try to contract to the shortest length possible (see diagram below). There is a sheet of platysma muscle on either side of the neck and this is why we develop the characteristic bands under our chin on the front of the neck as we age.

The changes do not stop there, however – we accumulate fat in the layer below the platysma which can create fullness under the chin and the submandibular salivary glands also enlarge increasing volume in the neck further. Additionally, another pair of muscles called the digastric muscles can also contribute to the fullness under the chin. The skin on your neck loses its elasticity, causing it to sag (driven by the underlying platysma muscle) and the layer of fat directly under the skin tends to get thicker with the aging process. All these factors contribute to the age-related changes we know and recognise. These changes are commonly referred to as a ’turkey neck’ or dewlap.

Ageing is inevitable, but its effects on your appearance don’t have to be. With advancements in cosmetic surgery, procedures like neck lift surgery can help combat these signs of ageing, restoring the youthful appearance of your neck.

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What is Neck Lift Surgery?

Neck lift surgery, as the name suggests, is a cosmetic surgical procedure designed to enhance the appearance of your neck. It involves tightening the loose platysma muscle, removing excess fat, trimming the submandibular glands and improving the overall contour of your neck. The aim of this procedure is to give your neck a more youthful and toned appearance.

During a neck lift surgery, I make incisions behind the ears and under the chin. I then lift the skin and subcutaneous fat off the platysma muscle. Next I look underneath the platysma and assess how much fat is there and whether some needs to be removed. Following this the submandibular glands are trimmed and if required, the digastric muscles are shaved to reduce their volume. The plastysma is then sewn together to make a single sheet of muscle (known as a corset – a corset platysmaplasty) which will address the bands in the neck and provide a smooth contour to the neck. The skin is then re-draped for a smoother, firmer look. Interestingly, there is not usually that much skin to be removed! The procedure generally takes around three hours and is performed under general anaesthesia.

Neck lift surgery is a popular choice among people looking to improve their appearance. It’s important to understand both the benefits and potential risks associated with this procedure before making a decision.

Benefits and Potential Risks of Neck Lift Surgery

There are numerous benefits to having neck lift surgery. It can significantly improve your appearance by giving your neck a youthful, toned look. Additionally, results from a neck lift surgery are long-lasting. With a healthy lifestyle and proper skincare, you can enjoy the results of your surgery for many years to come.

Like all surgical procedures, neck lift surgery also comes with potential risks. These include infection, scarring, bleeding, and adverse reactions to anaesthesia. There’s also a chance of nerve damage that could lead to weakness or numbness in the lower face. (It’s important to discuss these potential risks with Anthony before deciding to go ahead with the procedure).

The Best Age for Neck Lift Surgery

A neck lift is a surgical procedure that enhances the appearance of the neck by reducing sagging skin and tightening underlying muscles. While it’s a popular and effective way to address ageing signs in the neck area, there’s a common question that arises: What is the best age for neck lift surgery?

The answer is not straightforward. There’s no universally ideal age for a neck lift since the procedure’s suitability and timing depend on various individual factors, including genetic predisposition, lifestyle habits, and overall health.

Your inherent anatomical neck shape contributes greatly to the appearance of your neck and whilst the majority of patients seeking surgery are in the older age group generally associated with facial rejuvenation surgery, a significant minority of patients seeking surgery are in the 20’s to 40’s because constitutionally, they have an obtuse neck and are seeking to change their appearance rather than rejuvenate it.

What is the optimal age to have a neck lift?

In a lot of cases, individuals in their 40s to 50s seek neck lift surgery. The reasoning behind this is twofold:

  • Skin Elasticity: In your 40s and 50s, your skin typically retains some elasticity. Elasticity is crucial for the healing process and influences the surgery’s outcome. Skin that still has a degree of natural resilience tends to heal better and can adapt more naturally to the changes made during the surgery, resulting in a more natural and youthful appearance
  • Signs of Ageing: This age range is when many people start to notice more pronounced signs of ageing in their neck area. These can include sagging skin, the appearance of a ‘turkey neck,’ and visible banding in the platysma muscles. A neck lift at this stage can effectively address these issues, providing a rejuvenated look that aligns with the person’s overall facial ageing

For those in the 60s and over, although a neck lift can be performed as an isolated procedure, it is usually combined with a facelift as part of a general facial rejuvenation approach. Such is the importance of the shape of the neck when we assess how old we think someone is, the effects of a facelift are often markedly diminished if the neck is not addressed as part of the procedure.

Beyond Age: Other Crucial Factors

While age is a significant consideration, it’s not the only or even the primary factor in determining the right time for a neck lift. Other essential aspects include:

  • Physical Health: Good candidates for any surgery, including a neck lift, are those in good overall health. This minimises the risks associated with surgery and anaesthesia and aids in recovery
  • Skin Condition: The condition of your skin, rather than just its elasticity, plays a crucial role. Factors like extensive sun damage or severe skin laxity (including connective tissue disorders like Elhers Danlos syndrome) might affect the surgery’s outcome – if you have any concerns regarding this please ask me
  • Realistic Expectations: Understanding what the surgery can and cannot do is crucial. A neck lift can rejuvenate your appearance but won’t completely alter how you look. The best candidates have a realistic expectation of the results
  • Lifestyle Factors: Smoking, excessive alcohol consumption, and poor nutrition can adversely affect both the surgery and the healing process. A healthy lifestyle can contribute to better surgery results and a quicker recovery

How Age Impacts the Success of Neck Lift Surgery

Age plays a crucial role in the success of neck lift surgery. As mentioned earlier, skin elasticity diminishes with age. What is less well appreciated is that the dermis of the skin (the principle layer of the skin that contains the collagen and elastic fibres, blood vessels, sweat glands, hair follicles and nerve endings) becomes thinner. A sobering statistic is that when we are 20 our skin contains the maximum number of collagen fibres it ever will. By the time we are in our 70’s this has reduced to 20% of this number! The younger the skin, the better it can conform to the new contours of your neck after surgery. This leads to more natural-looking results.

But it’s not just about skin elasticity. Your age can also influence how quickly and effectively your body heals post-surgery. Younger bodies generally heal faster and more effectively than older ones.

That said, age is not the only determinant of success in neck lift surgery. Your overall health, skin condition, and lifestyle habits are equally important.

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Tips and Guidelines to Prepare for a Neck Lift Surgery

Preparing for neck lift surgery is as important as the procedure itself. Proper preparation can enhance the success of your surgery and speed up your recovery.

Before anything else, it’s important to have a detailed discussion with your plastic surgeon. Understand the procedure, the potential risks, and the expected results. Make sure you’re on the same page with your surgeon about your expectations.

Leading a healthy lifestyle is also crucial. Quit smoking, limit your alcohol intake, and maintain a balanced diet. This not only enhances the success of your surgery but also speeds up your recovery.

Make sure to arrange for someone to drive you home after the surgery and stay with you for at least the first night at home.

Ensure that you do not have to do any bending or lifting once you are at home – place everything you need to access at countertop height and have your grocery supplies in the fridge before you have the surgery – you won’t want to go out for the first few days and you don’t want to put your blood pressure up by carrying a heavy load for 2 weeks after the surgery.

You will want to have a few extra pillows to hand to keep you head above the level of your heart (it will reduce your venous blood pressure and hence reduce swelling).

FAQs about Neck Lift Surgery

Who is not a good candidate for a neck lift?

  • Individuals who may not be suitable candidates for a neck lift include those with significant health issues that impair healing or increase surgery risks, such as uncontrolled diabetes, heart disease, or blood clotting disorders. Smokers, who face increased complications in healing, are also advised against this surgery. Additionally, individuals with unrealistic expectations or a minimal amount of neck sagging might not benefit significantly from a neck lift. Patients need to have a thorough consultation with a qualified plastic surgeon to determine their suitability for this procedure.

Can a neck lift go wrong?

  • Like any surgical procedure, a neck lift carries certain risks, and complications can occur. These may include adverse reactions to anaesthesia, infection, haematoma (a collection of blood under the skin),  nerve injury leading to muscle weakness or numbness, scarring, and dissatisfaction with the cosmetic results. In rare cases, there might be issues with wound healing, especially in smokers. Patients must choose an experienced plastic surgeon and discuss all potential risks and outcomes before undergoing the procedure.

What is the next best thing to a neck lift?

  • For those seeking alternatives to a surgical neck lift, non-surgical options can provide some degree of improvement. These include injectable treatments like neuromodulator injections to relax neck muscles, dermal fillers for volume enhancement, and laser treatments or ultrasound therapy for skin tightening. Kybella injections can reduce fat under the chin. These methods are less invasive and typically have shorter recovery times but may offer more subtle and temporary results compared to a surgical neck lift.

Is a neck lift very painful?

  • Patients experience discomfort rather than severe pain after a neck lift. This discomfort can usually be managed with prescribed pain medication and tends to decrease significantly within the first few days post-surgery. It’s common to experience some swelling and bruising, which gradually improves over a few weeks. Each individual’s pain tolerance and healing process is different, and following Anthony’s post-operative instructions is key to a comfortable recovery.

How long do you wear a chin strap after neck lift?

  • The duration of wearing a chin strap after a neck lift can vary depending on your surgeon’s protocol and the specifics of the procedure. Generally, patients are advised to wear it continuously for the first week after surgery, except when cleaning the incision sites or showering. After the first week, it is often recommended to wear the chin strap at night for an additional few weeks to support healing and maintain the contouring effects of the surgery. I do ask my patients to wear a chin strap (though they are free to do so if they wish) as I use temporary external quilting sutures to close the dead space in the neck where blood can accumulate (which is what the neck strap is trying to prevent) but additionally these sutures help to redistribute any skin excess and can be used to help shape the jaw line. Please see my forthcoming blog on the subject for more information on these quilting sutures (technically called the haemostatic net). It’s important to remember to follow the specific instructions provided by myself or your surgeon for optimal results and recovery.

Further Reading about Face and Neck Surgery with Consultant Plastic Surgeon Anthony MacQuillan

Medical References about Neck Lift Surgery