A droopy or saggy neck is usually the single most bothersome facial change for men as they get older. Known as a neck wattle, this loose skin and fat causes a loss of a once sharper neck angle. This new roll of displaced neck skin can get in the way of shirt collars and is bothersome as it tends to flop around as one moves. Such neck wattles are usually not present before age 55 or older unless one has lost a lot of weight at a younger age.
While a conventional facelift is the ideal approach for an aging neck, men are much more sensitive about this procedure. Concerns about its recovery, visible scars around the ears, lack of a good hairline and hair density, where the scars would be, and the fear of being recognized of having had a facelift make many men shy away from its serious consideration.
INDIANAPOLIS
An alternative to a facelift in the older male is the direct neck lift. Rather than working the extra neck skin up and back to the ears (and the subsequent scars), the direct necklift removes the skin in the midline of the neck where it lies. This is a far simpler operation, with very little recovery, no pain other than a little neck tightness, and no change in the hairline or scars around the ears.
The obvious downside to a direct neck lift is that of the scar. Rather than it being around the ears as in a typical facelift, a midline scar running down the middle of the neck is created. While the direct necklift is far simpler and even more effective at creating a sharp neck angle, the pertinent question is what does the scar look like and how noticeable is it?
The best answer to that question is to look at actual neck scars from the procedure. In my Indianapolis plastic surgery practice, my experience shows that the scars are quite acceptable. I have yet to have a male patient tell me that they regret doing the procedure and consider the neck scar worse than their original neck wattle.
Why do the neck scars usually turn out quite well? Besides good operative technique, the main reason is the unique healing quality of bearded skin. Men's skin is thicker, has more blood vessels, and heals better due to the cellular contributions from the hair follicles. In addition, most men do a daily scar treatment after surgery, they shave. This is the equivalent of doing daily microdermabrasion scar treatments for years.
Not all neck scars will be perfect. A few will develop some thickening of the neck scar just above the adam's apple (thyroid cartilage) where the tension of the skin closure was greatest from the excision. For many men they do not feel that this is a problem. For others I treat it with some steroid injections or perform a small z-plasty in the office to relieve it in the first year after surgery.
The Scar From the Direct Necklift
Dr Barry Eppley is a board-certified premiere plastic surgeon in Indianapolis, Indiana where he practices at his Ology Spa locations at Clarian North Medical Center in Carmel Indiana and at Clarian West Medical Center in Avon Indiana.(http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com Dr. Eppley can be heard weekly on his radio show, Doc Chat, on WXNT 1430 AM every Saturday afternoon.
INDIANAPOLIS
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